How to take anticoagulants

Your doctor or nurse should tell you how much of your anticoagulant medicine to take and when to take it.

If you're unsure how to take your medicine, check the patient information leaflet that comes with it orask your anticoagulant clinic, GP or pharmacist what to do. You can also call NHS 111 for advice.

About youranticoagulant dose

For most people, anticoagulant tablets or capsules should be taken at the same time once or twice a day. It's important to take your medicine as scheduled because the effect of some anticoagulants can start to wear off withina day.

Warfarin , apixaban (Eliquis) and dabigatran (Pradaxa) should be taken with water. Rivaroxaban (Xarelto) is normally taken with food.

Depending on your dose, you may need to take more than one tablet or capsule at a time.

Warfarin tablets comein different colours (white, brown, blue and pink) to indicatetheir strength. You may need to take a combination of different coloured tablets to reach your total dose. Other anticoagulants come in different strengths and colours.

Your doctor or nurse will explain how many tablets you need to take, when to take them, and what the different colours mean.

Missed or extra doses

Warfarin

If you're taking warfarin and you miss one of your doses, you should skip the dose you missed and wait to take your next scheduled dose as normal. Don't take a double dose to make up for the one you missed.

If you accidentally take a dose that was much higher than recommended, contact your anticoagulant clinic or GP for advice.

Newer anticoagulants

If you're takingapixaban or dabigatran twice a day and you miss one of your doses, you should take it as soon as you remember if it's still more than six hours until your next scheduled dose. If it's less than six hours until your next dose, skip the dose you missed and take the next scheduled dose as normal.

If you accidentally take a double dose, skip your next scheduled dose and take the followingdose the next day as scheduled.

If you're taking rivaroxaban once a day and you miss one of your doses, you should take it as soon as you remember if it's still more than12 hours until your next scheduled dose. If it's less than12 hours until your next dose, skip the dose you missed and take the next scheduled dose as normal.

If you accidentally take a double dose,take your next dose the next day as scheduled.

Monitoring your dose

Warfarin

If you're takingwarfarin, you will need regular blood tests to check how quickly your blood clots. Thisis measured using the international normalisation ratio (INR).

Your INR willbe regularly tested at your GP surgery oranticoagulant clinic to make sure your blood doesn't clot too slowly or too quickly. Your warfarindose will be adjusted until your INR is in the correct range.

Your INR may need to be tested every other day at first until you're on the right dose. Once your INR stabilises in the correct range, these tests will be needed less frequently.

There are now home testing kits to monitor your INR. These mean youdon't need to go to your GP surgery or anticoagulant clinic for the INR test. This kit may be useful for some people, but you'll need training to use it and you'll usually need to pay for one yourself.

Speak to your doctor or nurse if you're considering using a home testing kit.

Newer anticoagulants

If you're takingapixaban, dabigatranor rivaroxaban, you won't need to have regular blood tests to monitor your INR.

However, you should still have appointments every few months to check you're taking your medication correctly and to discuss whether you've experienced any side effects.