Warfarin and Vitamin K

Warfarin and Vitamin K

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Topic Overview

Warfarin is a pill that you take regularly to help prevent blood clots or to keep a clot from getting bigger. Coumadin is the common brand name for warfarin.

To ensure that warfarin is effectively thinning your blood, it's important to eat about the same amount of vitamin K every day.

  • Vitamin K normally helps your blood clot so wounds don't bleed too much.
  • Warfarin works against vitamin K, making your blood clot more slowly.

So warfarin and vitamin K work against each other in your body. That is why, when you take warfarin, it's important that you not suddenly eat a lot more or a lot less vitamin K-rich food than you usually do.

How to get a steady amount of vitamin K

It's up to you how much vitamin K you choose to eat. For example, if you already eat a lot of leafy green vegetables, that's fine. Just keep it about the same amount each day.

And if you take a multivitamin that contains vitamin K, be sure you take it every day.

Check with your doctor before you make big changes in what you eat, such as starting a diet to lose weight.

Adding vitamin K

If you want to start eating more of a food that's rich in vitamin K, talk to your doctor about how to add it safely. Your warfarin dose may need to be adjusted.

Use this list to get an idea of what foods are sources of vitamin K.

Vitamin K content of select foods footnote 1

Food (no salt added)

Amount

Vitamin K (mcg)

Kale, boiled, drained

250 mL (1 cup)

1062

Spinach, frozen, boiled, drained

250 mL (1 cup)

1027

Spinach, boiled, drained

250 mL (1 cup)

889

Collards, boiled, drained

250 mL (1 cup)

773

Broccoli, boiled, drained

250 mL (1 cup)

220

Brussels sprouts, boiled, drained

250 mL (1 cup)

218

Cabbage, boiled, drained

250 mL (1 cup)

163

Spinach egg noodles, cooked, enriched

250 mL (1 cup)

162

Spinach, raw

250 mL (1 cup)

145

Broccoli, raw, chopped

250 mL (1 cup)

92

Lettuce, green leaf, raw

250 mL (1 cup)

46

Coleslaw, fast food

250 mL (1 cup)

135

Okra, boiled, drained

250 mL (1 cup)

64

Green peas, canned, drained

250 mL (1 cup)

63

Lettuce (such as romaine), raw

250 mL (1 cup)

48

Vegetables, mixed, frozen, boiled, drained

250 mL (1 cup)

43

Lettuce, butterhead (such as Boston or Bibb), raw

250 mL (1 cup)

56

Blueberries, frozen, sweetened

250 mL (1 cup)

41

Peas, edible pods, boiled

250 mL (1 cup)

40

Green peas, frozen, boiled

250 mL (1 cup)

38

Tuna fish, white, canned in oil, drained

85 g (3 oz)

6

Celery, raw

250 mL (1 cup)

30

Lettuce, iceberg, raw

250 mL (1 cup)

17

Kiwi, raw

1 fruit

5

Asparagus, boiled, drained

250 mL (1 cup)

92

Blackberries, raw

250 mL (1 cup)

29

Blueberries, raw

250 mL (1 cup)

29

Marinara sauce for pasta, ready-to-serve

125 mL (½ cup)

18

Cucumber, with peel, raw

125 mL (½ cup)

9

Canola oil

1 Tbsp

10

Olive oil

1 Tbsp

8

Pistachios, dry roasted, salt added

28 g (1 oz) [47 nuts]

3.7

Tea, brewed, prepared with tap water

175 mL (6 fl oz)

0.0

Green and black tea leaves do contain vitamin K before they are steeped in water, but a small serving of the hot tea itself does not.

Check with your doctor before you take any supplements or herbal products. Some of these may contain vitamin K. If you already take a product that contains vitamin K, do not stop taking it without talking with your doctor first.

How vitamin K and warfarin affect your risks and your test results

To find out how well warfarin is working, you will get blood tests to measure how long it takes for your blood to clot. Your lab results are called your Prothrombin Time (PT) and International Normalized Ratio (INR) values. You may just hear about your INR.

Your INR needs to be in a safe range—not too high and not too low. Vitamin K can change how warfarin works, which changes your INR.

  • Vitamin K lowers your INR values. The lower your INR, the less time it takes for your blood to clot. A low INR means that warfarin isn't working well enough to prevent a dangerous blood clot.
  • Warfarin raises your INR values. The higher your INR, the more time it takes for your blood to clot. A high INR means that warfarin is working too well, so you bleed more quickly and easily. This can be dangerous.

Keeping your warfarin and vitamin K intake steady every day helps keep you in a safe INR range.

References

Citations

  1. Agricultural Research Service (2015). USDA National Nutrient Database for Standard Reference, Release 28. Available online: https://ndb.nal.usda.gov/.

Other Works Consulted

  • Agency for Healthcare Research and Quality (2010). Blood Thinner Pills: Your Guide to Using Them Safely (AHRQ Publication No. 09-0086-C). Rockville, MD: Agency for Healthcare Research and Quality. Available online: http://www.ahrq.gov/consumer/btpills.htm.

Credits

Current as of:
January 10, 2022

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD - Internal Medicine
Brian D. O'Brien MD - Internal Medicine
Martin J. Gabica MD - Family Medicine
Adam Husney MD - Family Medicine
Rakesh K. Pai MD, FACC - Cardiology, Electrophysiology