How is the coumadin diet carried out? Nutrition while using Coumadin

Coumadin dietcan help you stay safe and reduce your risk of complications, some of which can be serious.

So, what foods should you eat and which should you avoid while taking Coumadin? Keep reading to find out.

What is Coumadin?

The FDA approved Coumadin, also known as warfarin, in 1954, and until recently, warfarin was the only drug approved to reduce the risk of stroke and heart attack in patients with atrial fibrillation.

The dosage of warfarin usually starts at two to five milligrams once a day. Your healthcare provider may increase your dose as needed to reach your therapeutic dose (the amount that keeps your blood at your target density). Still, the dosage usually does not exceed 10 milligrams per day.

Warfarin prevents vitamin K from producing blood clotting factors that promote clotting and thickening of the blood. Vitamin K is a nutrient found in certain foods and supplements.

Warfarin is most commonly prescribed to treat atrial fibrillation, a type of irregular heartbeat that can increase the risk of blood clots. Blood clots can travel to the heart, brain, or other veins and block blood flow, which can be fatal.

What are the side effects of Coumadin?

The most common side effects of warfarin are increased bleeding and bruising. You may have more nosebleeds or more bleeding from small cuts and scrapes than before you started taking warfarin.

Other potential side effects of taking warfarin include:

  • Gas
  • Abdominal pain
  • Swelling
  • Changing the taste of food
  • hair loss
  • chills or shivering

Signs of internal or other serious bleeding include:

  • Bloody, red, or tarry stools (a sign of intestinal bleeding)
  • spitting or coughing up blood
  • Heavy bleeding during the menstrual cycle
  • Pink, red, or dark brown urine
  • Coughing up or vomiting a substance that looks like coffee grounds
  • Small, flat, round red spots under the skin
  • unusual bruising or bleeding
  • Constant seepage or bleeding from small cuts

What products does Coumadin interact with?

The main nutrient interacting with coumadin is vitamin K. Vitamin K helps the blood clot, while warfarin does the opposite by trying to slow down the clotting.

Although many people taking warfarin have the impression that they should avoid foods rich in vitamin K altogether, this may not be the case. Vitamin K is found in many nutrient-dense foods, such as dark green vegetables, that can benefit your health.

The most important thing to consider when choosing foods with vitamin K is consistency in eating them. If you rarely eat foods containing vitamin K, you should avoid drastic changes and increasing your vitamin K intake.

What should not be eaten by patients taking Coumadin?

Remember that you don’t have to completely avoid vitamin K, but try to keep your intake consistent. You should avoid excessive intake of vitamin K, as it can cause more blood clots to form and can lead to a potentially fatal blood clot.

Foods Rich in Vitamin K

Foods with the highest content of vitamin K are leafy greens, as well as other green vegetables and herbs.

The highest content of vitamin K:

  • Lock
  • Spinach
  • turnip
  • beet leaf
  • dandelion greens
  • mustard greens

Other Moderate Vitamin K Foods:

  • Brussels sprouts
  • Broccoli
  • Onion
  • lettuce
  • Cabbage
  • Asparagus
  • Chicory
  • Parsley
  • Okra

Coumadin and nutrition

Always talk to your healthcare provider about your diet while taking warfarin, especially when it comes to making dietary changes.

The good news is that you don’t have to worry about foods containing vitamin K or other foods that interact with warfarin.

A balanced, healthy diet of protein, whole grains, and healthy fats is ideal when taking warfarin to support heart health. (Note that the most common reason warfarin is prescribed is for heart disease.)

Protein group

Choose lean protein sources whenever possible to promote heart health. Some good options include:

  • Bird (no skin)
  • lean beef
  • Fish
  • Egg
  • Beans and lentils
  • Soya

* Some soy products, such as natto (fermented soybeans), contain more vitamin K. You can probably safely eat other soy products instead of warfarin in moderation.

healthy fats

Foods rich in unsaturated fatty acids can promote healthy cholesterol levels and heart health.

  • Avocado (source of vitamin K, so eat in moderation)
  • Vegetable oils (olive, rapeseed, linseed, avocado oil, etc.)
  • Hazelnut
  • Seeds (especially flax and chia seeds)
  • Salmon, mackerel, sardines and other oily fish

Very high amounts of omega-3 fatty acids, such as fish oil and omega-3 supplements, can act as blood thinners. Eating foods rich in omega-3s reduces the risk of blood thinning compared to supplementing with high doses of omega-3s.

whole grains

Whole grains are rich in fiber and nutrients that can support your heart and overall health.

  • Whole grain bread, pasta, tortillas, crackers, etc. (no fortified flour)
  • oats
  • brown rice
  • Barley
  • Bulgur wheat
  • Millet
  • Popcorn

Foods Low in Vitamin K

There are many low vitamin K vegetables that you can safely enjoy while taking warfarin.

  • Artichoke
  • black beans
  • carrot
  • Cauliflower
  • Celery
  • Corn
  • Cucumber
  • chickpeas
  • green beans
  • Green pepper
  • porcini
  • Onion
  • wild carrot
  • Peas (½ cup)
  • Potato
  • pumpkin
  • radish
  • red cabbage
  • summer squash
  • sweet potato
  • Tomatoes
  • turnip


Some fruits contain some vitamin K (those marked with *), but they are probably safe to eat in moderation or in small amounts. Fruits do not contain as much vitamin K as dark green leafy vegetables.

Some fruits that are low to moderate in vitamin K include:

  • pears
  • apples
  • Banana
  • Strawberry
  • Citrus
  • Grape*
  • Blueberry*
  • Blackberry*
  • Pomegranate* and pomegranate juice*

Considerations for using Coumadin

There is no specific diet for Coumadin. Everything we eat can affect the role of warfarin. The Coumadin diet is mainly about the amount of vitamin K in our diet. The lower the amount of vitamin K, the more effective warfarin. And if there is a lot of vitamin K in our diet, then it reduces the effect of the drug.

Precautions While Using Coumadin


Alcohol can act as a natural blood thinner, preventing blood cells from clumping together. Drinking a lot of alcohol can increase your risk of serious bleeding while taking warfarin, so if you decide to drink, try to keep your alcohol intake to a moderate level.

Pregnancy / Breastfeeding

Blood thinners such as warfarin should not be taken during pregnancy. Taking these blood thinners can increase the risk of bleeding (loss of large amounts of blood due to a ruptured vessel) and problems for both mother and baby.

Anticoagulants are prescribed during pregnancy only if the potential benefits outweigh the risks. If you are taking blood thinners and plan to become pregnant, you should tell your doctor right away.

Grapefruit juice

Grapefruit juice interacts with many medications and can interfere with how they work. Compounds in grapefruit juice can increase blood levels of warfarin, which can cause more bleeding. Do not drink grapefruit juice while taking warfarin.

Some additives

Some supplements contain vitamin K. You should talk to your healthcare provider or pharmacist if you are taking any herbal or dietary supplement, such as:

  • angel grass
  • anise seeds
  • asafoetida
  • Daisy
  • echinacea
  • cement grass
  • Garlic
  • Ginger
  • Ginkgo biloba
  • ginseng
  • horse chestnut
  • sweet clover
  • Cabasia
  • Red clover
  • Spirulina
  • Tonka bean

Omega 3 supplements

Omega-3 supplements, including fish oil, may act as an anticoagulant. They should also be discussed with your doctor while taking warfarin.

Green juice drinks

Drinks made with dark leafy green vegetables (green juices or green drinks) may contain significant amounts of vitamin K. Avoid these types of drinks as they may also interact with the medication.

Foods rich in vitamin K promote blood clotting, and warfarin slows down blood clotting.

Try to eat foods rich in vitamin K in moderation. To be on the safe side, avoid eating large portions of foods that are very high in vitamin K, such as spinach, kale, and other dark leafy greens.

While taking warfarin, eat a heart-healthy diet that includes high-quality lean protein, whole grains, healthy fats, and a variety of low-to-moderate vitamin K-containing fruits and vegetables.

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