ANTICOAGULATION MEDICATIONS Warfarin (Coumadin)—This oral medication is used to treat blood clots. Regular lab testing is required to measure the international normalized ratio (INR) level in the blood to make sure the correct dosage is given and to prevent complications of warfarin therapy. Many drugs and foods, including infant formula, can interfere with how warfarin works because they contain high amounts of vitamin K, which alters the INR test result. Eating the same amount of foods high in vitamin K daily can help avoid changes in the medication level in your child’s body and can help avoid fluctuating lab results. Antibiotics can interfere with warfarin, so if your child becomes ill and is taking an antibiotic, notify your healthcare provider to get needed instructions. Enoxaparin (Lovenox)—This is a type of heparin (low-molecular-weight heparin) given by injection under the skin (subcutaneously) to treat blood clots. This medication requires regular lab testing specifically timed 4–6 hours after the injection is given to ensure that the correct dosage is maintained. Ongoing lab testing of the low-molecular-weight heparin level (or anti-Xa level) monitors dose effectiveness in treating the clot.
Rivaroxaban (Xarelto)—This oral medication (taken by mouth) is used to treat blood clots. Regular lab testing may be required to monitor how well the dose is working and to prevent complications. Tell all of your child’s healthcare providers that your child is taking this drug. Your child may need to stop taking this drug before some types of surgery, per your child’s doctor’s instructions, and the doctor will tell you when to start giving this drug again after a surgery or procedure. SIDE EFFECTS OF ANTICOAGULATION MEDICATIONS The most common side effects of these medications are bleeding and the development of new clots, due to over- or underdosing of a medication. Monitoring the dosages by Regular lab testing is important to monitor the effectiveness of your child’s dosage so that you can reduce the risk of bleeding (if too much medication is being given) or new blood clots (if not enough medication is being given).
HOW CAN I WORK WITH THE HEALTHCARE TEAM? Your child’s care requires a team approach, and you’re a key player on their healthcare team. You know your child better than anyone else, and your input is important. Other members of your child’s healthcare team include doctors, nurses, pharmacists, and social workers.
Always communicate openly with the members of your child’s healthcare team. If there is anything you are not sure about, ask the team. Write down your questions as you think of them so you’ll remember to ask them during your next meeting with your healthcare team. Important questions you may want to ask include • What treatment choices are available? • What treatment do you recommend and why?
• What are the risks or side effects during treatment? • What are the risks and side effects after treatment? • What are the chances that the thrombophilia or blood clot will remain or continue after treatment?
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