1. To prevent the formation of thrombosis in the blood, regular blood testing.
2. Precautions for medication: Try to avoid trauma and bleeding in daily life, such as: bruising, massaging, cutting vegetables too quickly; choose a soft-bristled toothbrush; men, please use an electric razor to shave. Apply pressure around the site about 10-15 minutes.

To prevent the formation of thrombosis in the blood, regular blood testing  (international normalized prothrombin time ratio, INR) as the basis for adjusting the dose of drugs, preventing and treating thrombosis and reducing the risk of bleeding.

II.Usual medicine of anticoagulant in VGHTC：

    1. Precautions for medication:

• In case of red stool (pitaya with red skin and purple meat) or black stool (iron, pig blood, chicken blood, duck blood, goose blood, sheep blood, cherries, chocolate, raisins) caused by eating food or drugs Waiting for food), please continue to observe the color of the stool.

• Try to avoid trauma and bleeding in daily life, such as: bruising, massaging, cutting vegetables too quickly; choose a soft-bristled toothbrush; men, please use an electric razor to shave. Apply pressure around the site about 10-15 minutes.

• Immediate return to hospital for blood test: A. Hematuria, bloody stool, vomiting blood, hemoptysis, eye hemorrhage, more than usual menstrual blood volume and bleeding due to non-external injury (gum bleeding, nosebleed, severe bruising). Physicians will adjust the dose of the drug, Do Not stop the drug by yourself.

• If you forget to take the medicine, make up the daily dose, take the medicine at the original scheduled time and dose the next day, and inform the doctor when you return to the doctor about the time you forgot to take the medicine.
• Anticoagulants mainly reduce the blood coagulation function. The doctor will decide the medication time according to your condition. If you take it incorrectly, it may cause severe bleeding. Please be sure to follow the dosage prescribed by the doctor. Do Not stop or increase or decrease the dose by yourself.
• If you need to receive any invasive examination and treatment ( eg : dental treatment , microscopy examination, cardiac catheterization, etc. ) or surgery, the physician must be informed are taking anticoagulant drugs so that they can be properly treated before receiving treatment to reduce bleeding.

•  Avoid the interaction between traditions Chinese medicine and medicine.
• Taking anticoagulant during pregnancy may cause fetal malformation please inform your doctor before you plan to be pregnant or breast-feeding. 

IV.What do I need to know about warfarin and my diet?

1. Prohibition of consumption Natto Capsules and Soy Lecithin Extract Health Food Capsules.
2. How to avoid the lack of anticoagulants when taking anticoagulants? Diets with high vitamin K content and Chinese medicines and Western medicines can cause insufficient anticoagulants. Please follow the recommendations below:

• Poor diet habits, Taking Chinese medicine and Western medicine will lead to anticoagulant overdose or inhibit platelet function by itself, and there is a risk of bleeding when taken together.
• Please follow the recommendations below: Forbidden to eat: ginseng, western ginseng, ginkgo, ganoderma, angelica Oriental ginseng, Jilin ginseng, red dates, wolfberry, ginger garlic, Hypericum perforatum (hypericum perforatum), Turtle and Deer Gum, Ginger, Pineapple Enzyme and Papaya. Enzyme.

Know the signs and symptoms of blood clots, bleeding, and a stroke. Make sure that you know your target INR with blood tests. Make sure you discuss any questions you have with your health care provider.

VI. Reference

1. 臺中榮民總醫院(2020)．臺中榮總藥品手冊查詢系統．  取自http://www3.vghtc.gov.tw: 8080/ pharmacyHandbook/
2. Elango, K., Javaid, A., Khetarpal, B. K., Ramalingam, S., Kolandaivel, K. P., Gunasekaran, K., & Ahsan, C. (2021). The effects of warfarin and direct oral anticoagulants on systemic vascular calcification: A Review.Cells,10(4), 773. https://doi.org/10.3390/cells10040773
3. Grześk, G., Rogowicz, D., Wołowiec, Ł., Ratajczak, A., Gilewski, W., Chudzińska, M., Sinkiewicz, A., & Banach, J. (2021). The clinical significance of drug-food interactions of direct oral anticoagulants. International journal of molecular sciences, 22(16), 8531. https://doi.org/10.3390/ijms22168531