Hackensack University Medical Center established the Anticoagulation Service to meet the specific needs of patients who take blood-thinning medication. A patient on long-term anticoagulation drug therapy must be closely monitored to assure safe and effective treatment. The Anticoagulation Service helps these patients maintain optimal health though a coordinated process of care in partnership with the patient and his or her referring physician. The program’s multi-disciplinary healthcare team works closely with referring physicians to effectively manage each patient’s anticoagulation therapy. (For more information about these healthcare professionals, click Who We Are. )

(Click on the blue ball for each topic.)
Anticoagulation Drugs  Anticoagulation Drugs
Management of Anticoagulation Drug Therapy  Management of Anticoagulation Drug Therapy
Highlights of the Anticoagulation Service  Highlights of the Anticoagulation Service
Drug and Food Interactions of Anticoagulation Therapy  Food and Drug Interactions of Anticoagulation Therapy
Adverse Symptoms Reference List  Adverse Symptoms Reference List
Hours of Operation / Locations  Hours of Operation / Locations
How To Enroll in the Program  How To Enroll in the Program
Educational Resources and Web Links  Educational Resources and Web Links



Anticoagulation Drugs Description: Anticoagulants are medications used to treat or prevent a blood clot, which is a small amount of blood that has formed into a semi-solid mass. A clot can create a potentially dangerous medical condition if it causes a blockage of blood flow in a vein, vessel, or artery. Anticoagulants work by thinning the blood, thus reducing the chance that a clot will form. This is important in the prevention of heart attacks, strokes, pulmonary embolisms, and other conditions caused by blockages in the bloodstream.

Types of Anticoagulants: Some of the more commonly prescribed anticoagulants are listed below. Each drug is listed with its generic name first, followed by the brand name. The generic name of a drug is usually descriptive of its chemical structure and not protected by a trademark:

  • Warafin (Coumadin®)
  • Heparin
  • Clopidogrel (Plavix®)
  • Dipyridamole (Persantine®)
  • Enoxaparin (Lovenox®)
  • Ardeparin (Normiflo®)
  • Dalteparin (Fragmin®)
  • Ticlopidine (Ticlid®)
  • Danaparoid (Orgaran®)
  • Tinzaparin (Innohep®)
  • Aspirin
  • Thrombin Inhibitors
        (available in the near future)

    • For more specific information about a particular drug, click here to search the online drug information database of the     National Library of Medicine.

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    Why are anticoagulants prescribed? Anticoagulants are generally prescribed for patients who have a disease or condition that places them at risk for the formation of blood clots. Some of the more common indications for anticoagulation drug therapy include:

  • Stroke
  • Heart Attack
  • Heart Valve Disease
  • Coronary Artery Disease
  • Heart Failure
  • Arrhythmia
  • Atrial Fibrillation
  • Deep Vein Thrombosis
  • Pulmonary Embolism
  • Active Cancer
  • Preventive Therapy after Major Surgery
  • Preventive Therapy for Bedridden Patients

    • What are the benefits and risks of anticoagulation therapy? If you have a condition that places you at risk for a blood clot, then anticoagulation therapy reduces that risk by thinning the blood. However, if the blood becomes too thin, then your ability to form a clot takes longer, which places you at risk for bleeding. Such an adverse reaction does not happen spontaneously, but may occur if you are injured or if an underlying medical problem resurfaces. Minor bleeding presents as bleeding gums or blood in the urine, but more serious internal bleeding can have severe medical consequences. This is why the management of anticoagulation drug therapy is so important. (Click Adverse Symptoms for more information.)

    Management of Anticoagulation Drug Therapy
    The Anticoagulation Service does not replace your routine medical care; rather, it is a supplemental system that provides safe and effective anticoagulation drug therapy, monitoring, and education. The service assures that you achieve and maintain the proper dose of anticoagulation medication. It serves a supplemental role in your overall medical plan while you continue to be under the care of your primary physician.
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    Highlights of the Anticoagulation Service Medical Monitoring / Prescriptions: The medical professionals of the Anticoagulation Service closely monitor the course of your drug therapy and your response to the medication. This means that you have the benefit of a one-on-one relationship with a nurse practitioner who will help you navigate the course of your therapy, offer individualized education, coordinate your follow-up care, and provide written prescriptions for anticoagulation medication whenever needed.

    State-of-the-Art Blood Testing: The Anticoagulation Service is equipped with the CoaguCheck™ System, a sophisticated unit that eliminates the need for full vials of blood to be drawn from a patient and sent to a laboratory. Similar to a diabetic glucose monitoring system, the CoaguCheck™ System requires only a small drop of blood using the finger stick method. Results of this test are available within minutes, which enables the nurse practitioner to make any necessary dosing changes during your visit.

    The blood measurement most commonly used to determine the amount of anticoagulation medication in the body is the     Prothrombin Time (PT) test, which has been standardized as the International Normalized Ratio (INR). PT/INR tests are needed at periodic intervals throughout the course of therapy to guide dosage recommendations. The goal of this precise monitoring is to maintain the safest and most effective blood levels of the anticoagulant for your specific medical condition.

    Computerized Access of Blood Test Results: Your referring physician is able to view reports of your progress and blood test results through an advanced tracking system called HEARTFIRST CareTrax™ Patient Profile Wizard™. Physicians have access to this online reporting tool through the Hackensack University Medical Center intranet computer system. Your physician gains access to your record with a password, and then is able to view reports that include laboratory and medication history, adverse events history, and patient encounter workflow chart.

    Individualized Educational Counseling: The nurse practitioner of the Anticoagulation Service will teach you strategies to effectively manage your anticoagulation therapy and maintain optimal health. Important educational topics include: Nutritional Guidance / Pharmaceutical Consultation: Patients enrolled in the program will have opportunities to speak with a nutritionist and a pharmacist about the food and drug interactions of anticoagulation therapy and how they may interfere with the drug’s effectiveness.
    The Anticoagulation service regularly hosts group classes on these topics for all registered patients. To inquire about the date for an upcoming class, call 201-996-4997.
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    Medic Alert Identification: All patients taking anticoagulants are advised to have Medic Alert identification so they will be properly treated in the case of an emergency. The Anticoagulation Service provides assistance in obtaining this important means of providing medical information. (For more information about this important service, click Medic Alert or call 800-432-5378.)

    Travel Arrangements: If you plan to travel and are unable to keep your follow-up blood testing schedule, the Anticoagulation Service will assist you in making arrangements for alternate testing while you are away.

    Food and Drug Interactions of Anticoagulation Therapy Food Interactions: Foods rich in Vitamin K can reduce the effectiveness of anticoagulation drug therapy. Anticoagulants work by partially blocking the liver’s use of Vitamin K, which is an essential nutrient needed to make clotting factors and prevent bleeding. For this reason, it is important that the amount of Vitamin K in your diet remains consistent so that your controlled medication rate is not erratic. Sudden changes in your consumption of Vitamin K-rich foods should be avoided. The nurse practitioner will provide specific nutritional guidelines about the levels of Vitamin K recommended during anticoagulation therapy during your individualized educational counseling.

    Vitamin K is found naturally in leafy, green vegetables, such as broccoli, cabbage, spinach, cauliflower, and brussel sprouts. Other foods rich in Vitamin K include fish, liver, lentils, soybeans, and certain vegetable oils. (Click here for a listing of Vitamin K-Rich Foods. )

    Drug Interactions: The effectiveness of anticoagulation therapy is affected by certain drugs (both prescribed and over-the-counter), alcohol (which should be avoided), and nutritional/herbal supplements. During anticoagulation therapy, the introduction of a drug or supplement or the alteration in the dosage of one you already take can result in unanticipated changes in the levels of anticoagulant medication in your bloodstream. The nurse practitioner of the Anticoagulation Service or your prescribing physician must be informed of these alterations because if appropriate dosage adjustments are not made, then the anticoagulation control will be erratic. (Click here for more information about the Interaction of Anticoagulation Therapy with Drugs, Nutritional Supplements, and Herbal Preparations.)
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    Adverse Symptoms Reference List
    The following symptoms should be reported immediately to your physician and the Anticoagulation Service staff:
    • prolonged bleeding from cuts
    • nose bleeds
    • bleeding gums while brushing your teeth
    • red or dark brown urine
    • lightheadedness or fainting
    • cold, blue, or painful feet
    • new redness of leg or feet
    • coughing up blood
    • red or dark brown stool
    • vomiting material that looks like coffee grounds
    • worst headache of your life (unlike any other you have had in the past)
    • increased menstrual flow or vaginal bleeding
    • pain, swelling, or discomfort in the legs, or
    • severe abdominal or back pain.
    You should also call your physician and the Anticoagulation Service if you are sick (i.e., vomiting, diarrhea, fever) for more than a few days. Illness sometimes can change the effect of anticoagulant therapy.

    Hours of Operation / Locations
    The office locations and hours of operation of the Anticoagulation Service are:

    Days Monday to Friday
    Hours 8 a.m. to 4:30pm
    Hours by Appointment
    Call 201-996-4997
    Other Hours Available as Needed
    Location Hackensack University Medical Plaza
    The Heart Center
    Second Floor, Room 200-80

    How To Enroll in the Program
    If you are interested in enrolling as a patient in the Anticoagulation Service, you should first discuss it with your physician who will evaluate whether participation is appropriate for you. Once your physician recommends participation, you can register by calling 201-996-4997. The professional staff of the Anticoagulation Service will then work with your physician to develop a treatment plan for your care.

    Most insurance plans, including Medicare, cover participation in the Anticoagulation Service. We will be more than happy to assist you with any questions regarding coordination of your benefits and payment terms. For help with these matters, call 201-996-4997.

    Educational Resources and Web Links
    Consumer Information about Coumadin
    National Library of Medicine
    Warfarin Information Site

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