Anticoagulation Clinic

Warfarin helps to control the blood’s ability to clot and is prescribed to prevent harmful clots from forming or to treat harmful clots that already have occurred (such as a clot in the leg (called a DVT, Deep Vein Thrombosis), a clot in the lungs (called a Pulmonary Embolus), or a clot in the brain (stroke)). Your Warfarin needs to be carefully monitored regularly to prevent bleeding and clotting.

Warfarin (Coumadin®) requires regular monitoring by a blood test called the INR (International Normalized Ratio). Sometimes the term “Pro-Time” is also used. This test requires you to go to a Kaiser lab to have this test done.

Have your INR/”Pro-time” blood test done before 11 a.m. on the day of your scheduled lab appointment or have your blood drawn any time it is convenient for you the day before your scheduled appointment. Please avoid having your INR done on Fridays, unless specifically advised by the Anticoagulation Pharmacist.

There is a standing order on file for you at the laboratory reception desk. Identify yourself as a “Coumadin® or warfarin patient being followed by the Anticoagulation Clinic.”

1. If your result does not require a change in your warfarin dose, the anticoagulation clinic will mail you a letter that should arrive in 2 to 3 days with your INR result OR will email you the result confidentially by the Kaiser Permanente website Kp.org.
2. If your result requires a change in your warfarin dose, you will receive a call from the Anticoagulation Pharmacist with your INR result within 24 hours of your blood test.
3. If you have not received a call, letter, or email from the clinic and it has been longer than 2 to 3 days after your lab test, please call the Anticoagulation Clinic at 707-645-2520 or e-mail your Coumadin® Pharmacist at Kp.org.
4. An additional reminder: For patients with INR results that do not require a dose adjustment in their warfarin and who have registered online with Kp.org, we can email your results. Please call the clinic for more details about this new offering.
5. DO NOT CHANGE YOUR WARFARIN DOSE ON YOUR OWN BASED ON LAB RESULTS YOU SEE ON THE KAISER PERMANENTE WEBSITE.

We strongly advise you click on the links below for more information about your Warfarin.
Regional Patient Info About Warfarin (PDF)
Warfarin Interactions (PDF)
Warfarin-Herbal Interactions (PDF)

Please call the Anticoagulation Clinic:

• If you have any sign or symptoms of bleeding or clotting.
• If you miss 1 or more doses of your warfarin (Coumadin®).
• If another health care provider changes your dose of warfarin (Coumadin®).
• If you have changed your address or telephone number(s).
• If you plan to be out of town or on vacation for an extended period of time.
• To report any new medications (prescription, herbal, OTC) or changes in medications.
• Before taking antibiotics for any reason.
• If sudden changes occur in your health (e.g.: infection, flu, diarrhea, vomiting, fever, etc.).
• To report any major dietary changes (e.g.: starting Weight Watchers, Jenny Craig, South Beach Diet, Atkin’s Diet, low fat diet, or drinking nutritional supplements like Slim Fast, New Basics, Ensure, Carnation Instant Breakfast, Glucerna, and the like).
• At least 7 days before any upcoming medical or dental procedure or surgery.
• Within 48 hours of any visit to the Emergency Room, Hospital Discharge, or worsening of your overall health.
• If you have not received a call or letter from the clinic within 2 to 3 days after your blood test.

Anticoagulation Clinic Manager:
Kerri M. Butler, Pharm.D

Anticoagulation Clinic Supervisor:
Emily Moran, Pharm.D.

Anticoagulation Clinic Advising Physician:
Bradley Lewis, M.D.

Anticoagulation Clinic Pharmacists:
Tamara Hetler, Pharm.D., Lead Clinic Pharmacist
Yuliya Bogorad, Pharm.D
Leo M. Kiang, Pharm.D
Quinn Le, Pharm.D
Isabel Martinez, Pharm.D

Anticoagulation Clinic Pharmacy Technicians:
Desi Bito
Sheryl Castro
Azucena Mejia
Carrie Ribeiro
Adrianne Walmsley