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Anticoagulation Clinic

If you regularly take certain anticoagulant medications ("blood thinners") most commonly warfarin (Coumadin), you may be referred to the UCSF Anticoagulation Clinic. Our team of experts includes specially trained pharmacists and nurse practitioners who closely monitor and manage your medications.

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Getting Here

Anticoagulation Clinic
350 Parnassus Ave., Fourth Floor, Suite 410
San Francisco, CA 94143-0325
Phone: (415) 353-2143
Fax: (415) 353-2890

Hours: 8:30 a.m. – 4:30 p.m.

What to Bring

  • Health insurance information including authorizations or referrals
  • List of prescription medications and dosages
  • List of medications that you're allergic to
  • List of questions you may have
  • Recent test results related to your condition
  • Paper and pencil to take notes

Research and Clinical Trials

What We Manage

Which medications does the Anticoagulation Clinic usually manage?

  • Warfarin (Coumadin)
  • Enoxaparin (Lovenox) and other injectable anticoagulants
  • Dabigatran (Pradaxa)
  • Rivaroxaban (Xarelto)
  • Apixaban (Eliquis)

Who needs anticoagulant medicine?

Anticoagulant medications reduce the body's ability to form blood clots. Some people call anticoagulants "blood thinners," but they do not actually "thin" your blood. Instead, they slow the rate at which blood clots. We care for patients taking anticoagulant therapy for a variety of conditions, including:

  • Atrial fibrillation (irregular heart beat)
  • Deep vein thrombosis (DVT) or pulmonary embolism
  • Artificial heart valves
  • Other clotting problems

Why is a special clinic needed to monitor my medication?

While anticoagulant medications are very effective in preventing stroke and other complications, they can be dangerous if not closely monitored. While on warfarin, your international normalized ratio (INR) must be regularly checked with a blood test. The INR can determine how well your warfarin is working by measuring how long it takes your blood to clot. Your provider will adjust your warfarin dose depending on the results of your INR tests.

For patients taking warfarin, your INR should be checked approximately once a month the INR may need to be checked more often when you first start warfarin, when changes are made to your other medications, or if your INR results are not within the therapeutic range.

  • If your INR is too high, blood clots will not form quickly enough and you may experience bruising or you may be at increased risk of bleeding. In this case, your dose may need to be reduced.
  • If your INR is too low, your medication is not working sufficiently, which means that clots could still form and block a blood vessel. In this case, your dose may need to be increased.

Anticoagulation side effects

The most serious potential side effect of anticoagulants is excessive bleeding. If you experience any of the following, seek medical attention right away and have an urgent INR test.

  • Prolonged nosebleeds (more than 10 minutes)
  • Coughing up blood
  • Passing blood in your urine or stool
  • Passing black stools
  • Severe or spontaneous bruising, or any bruise which limits the motion of a joint
  • Unusual headaches
  • For women, heavy or increased bleeding during your period or any other vaginal bleeding

First Appointment

You will need a referral from your doctor to make an appointment at the UCSF Anticoagulation Clinic. Most of our patients are referred by their primary care doctor at the General Internal Medicine Clinics, but we also accept patients from all clinics at UCSF.

Your first visit will take approximately one hour. Future visits will be brief, unless you or your health care provider have a special issue to discuss.

Before an appointment is scheduled, you may be asked to provide a copy of your medical records for review by our nurses. The results of any diagnostic tests already completed also will be requested to ensure that tests aren't repeated unnecessarily.