Coumadin is an effective blood thinner that must be used with caution. For this reason, it isn't used in patients who already have a tendency to bleed easily, such as those with bleeding ulcers, kidney failure, or liver disease, or who tend to fall a lot or have unsupervised dementia, Gage says. Those who do use Coumadin must get a fingerprick blood test every three to four weeks, to be sure they have just the right amount of medication in their body. Too much can lead to potentially dangerous bleeding, and too little can lead to formation of a blood clot. For those who can't do this, Gage often recommends aspirin instead.
Patient preferences are an important part of the shared decision-making process.
Thomson is professor of epidemiology and public health at the University of Newcastle School of Medicine in England. Although the problems associated with Coumadin may also increase with age, the benefits of use may be even greater in those who are older, he says. If a blood clot travels from the heart to the brain, it can cause a stroke. Previous studies have shown that blood thinners like Coumadin are safe to use in patients aged 65 to 75. A new study shows the drug is safe to use in patients over 80, but overall, the therapy is underused.