Daily life while taking VKAs

Pregnancy, breastfeeding, and fertility

Pregnancy

If you become pregnant, it is important to tell your clinic as soon as possible. If you miss your period, or think you might be pregnant, you should do a pregnancy test as soon as possible. Usually, you will stop taking VKAs and start having anticoagulant injections throughout your pregnancy. These injections are safe for you and your baby.

If you are of child-bearing age and have a mechanical heart valve, you should talk to your heart specialist (cardiologist) about family planning. You will need to discuss options for anticoagulation treatment if you become pregnant. This may include continuing the VKAs.

Taking VKAs between weeks 6 and 12 of pregnancy means there is a small risk of development problems for your baby. If taken in the third trimester there can be a risk of bleeding for the fetus. After delivery, there is also a bleeding risk for the baby if VKAs are used close to delivery.

Breastfeeding

It is safe to take VKAs when breastfeeding.

Fertility

VKAs do not affect fertility and are not associated with any development issues if taken at the time of conception.

VKAs and other medicines

VKAs does not mix with other medicines. They might increase or decrease your INR, and increase your risk of bleeding or a blood clot.

Always check with the person prescribing your medicine, that it is safe to take with your anticoagulant. Also tell your clinic when you have your INR, by writing it on your dose slip.

If you stop taking a medicine, it is also important to tell your clinic.

VKAs and supplements

Lots of supplements do not mix well with VKAs. Please check with your clinic before starting any supplements.

VKAs and foods

Foods rich in vitamin K do not mix with VKAs and can affect your INR.

You do not need to avoid any of these foods. However, we advise you to have regular portions of these foods in your diet every week, to help maintain a consistent INR.

You need to avoid cranberry juice while taking VKAs, as it increases your INR.

Some foods high in vitamin K are:

• broccoli
• cabbage
• curly kale
• Brussels sprouts
• spinach
• chickpeas
• liver
• egg yolks
• bran
• oats
• blue cheese
• avocado
• olive oil

VKAs and alcohol

Alcohol can increase your INR and risk of bleeding. If your drinking habits change (this includes drinking less as well as more), please tell your anticoagulation clinic on your dose slip when you have your INR.

You do not need to stop drinking alcohol completely, but you should not binge drink while taking VKAs. We recommend staying within the national alcohol limits of 14 units each week, spread across 3 or more days.   

Surgery and dental appointments

If you need surgery or a hospital procedure, you must tell the surgeon and their team that you are taking VKAs. You will need a "bridging plan" for how to manage your VKAs before and after surgery. Depending on where you live, this will be done by your anticoagulation clinic or your surgical team.

You need to let your dentist know you are taking VKAs. You might not need to stop taking VKAs for routine dental checks and procedures, but your dentist will decide this.

Getting your prescriptions

Your GP will write your prescriptions in the long term. Please make sure that you request your medicines in plenty of time so that you do not run out.

Your GP and pharmacy will need proof that your INR is being monitored before they can give you the VKAs. It is your responsibility to present your dosing slips or yellow book when:

• you request a prescription from your GP
• you collect your prescription from the pharmacy

Anticoagulant alert card

When you start taking VKAs, you should be given an anticoagulant alert card. Please carry this with you at all times in case of an emergency. It gives vital information to healthcare professionals about you taking an anticoagulant. You may also want to update your mobile alert records to contain this information.

Support and more information

The British Heart Foundation has lots of information about related heart conditions. Helpline: 0808 802 1234, Monday to Friday, 9am to 5pm (excluding bank holidays)