Warfarin: Any harm in long-term use?

  • image.alt
  • With Mayo Clinic emeritus hypertension specialist

    Sheldon G. Sheps, M.D.

    read biography

Mayo Clinic Health Manager

Get free personalized health guidance for you and your family.

Get Started

Free

E-Newsletter

Subscribe to receive the latest updates on health topics. About our newsletters

  • Housecall
  • Alzheimer's caregiving
  • Living with cancer

Question

Warfarin: Any harm in long-term use?

Is there any harm in taking warfarin for an extended period? My doctor prescribed it after I had an episode of deep vein thrombosis. I'd like to continue taking it for peace of mind.

Answer

from Sheldon G. Sheps, M.D.

Warfarin (Coumadin) is a blood-thinning medication (anticoagulant) used to treat and prevent blood clots. For most people with a single episode of deep vein thrombosis (DVT), treatment with full-dose blood thinners is usually for only a limited time.

Long-term, low-dose treatment with warfarin may prevent future episodes of DVT, but it's not without risk. There's a risk of serious or even fatal bleeding — especially when warfarin is taken in high doses or for long periods of time. Taking warfarin at a high dose for a longer period of time is only recommended for people who are at a high risk of developing blood clots that could cause a heart attack, stroke or pulmonary embolism.

Ask your doctor to help you weigh the benefits and risks of long-term low-dose warfarin therapy in your case. Also consider these self-care measures to prevent future episodes of DVT:

  • Avoid sitting, squatting or crossing your legs for long periods of time.
  • If you must sit for long periods, such as during a plane or car ride, take a short walk every hour. It also helps to flex your ankles, curl your toes and tap your feet frequently.
  • Drink plenty of fluids to prevent dehydration.
  • Wear support hosiery or compression stockings, available at medical supply stores.

If you're taking warfarin to prevent blood clots that could cause a heart attack or stroke, make sure you take it exactly as prescribed. Warfarin is a powerful medication that can have dangerous side effects.

References
  1. Ridker PM, et al. Long-term, low-intensity warfarin therapy for the prevention of recurrent venous thromboembolism. New England Journal of Medicine. 2003;348:1425.
  2. Kearon C, et al. Comparison of low-intensity warfarin therapy with conventional-intensity warfarin therapy for long-term prevention of recurrent venous thromboembolism. New England Journal of Medicine. 2003;349:631.
  3. Kearon C, et al. Influence of thrombophilia on risk of recurrent venous thromboembolism while on warfarin: Results from a randomized trial. Blood. 2008;112:4432.

HQ01614

March 27, 2009

© 1998-2009 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "EmbodyHealth," "Reliable tools for healthier lives," "Enhance your life," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.

Print Share Reprints

Text Size: smaller largerlarger