Anna D. Garrett, PharmD, BCPS, CPP
Published Online: Tuesday, August 1, 2006

Patients taking warfarin often have questions related to eating green leafy vegetables. Well-meaning family members, friends, and health care providers may tell them that they should avoid foods high in vitamin K (generally, green leafy vegetables and some oils). Adopting this advice, however, may make stabilization of the international normalized ratio (INR) difficult.

If a patient has a diet that is very low in vitamin K intake, any increase in green leafy vegetables represents a large percentage increase in vitamin K, and a large drop in the INR. Patients with diets already high in vitamin K who increase their intake of green leafy vegetables will have a much lower percentage increase.

Dr. Garrett is a clinical pharmacist practitioner at Cornerstone Health Care in High Point, NC.

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