Patient/Family Decision Aid
Warfarin or Enoxaparin
You need to take medicine to help prevent blood clots. This decision aid will help you choose which
medicine you would like to take.
Warfarin and enoxaparin both keep blood clots from forming; they just work in different ways. This
chart will show you the differences between the medicines. Think about what might be the better
choice for you.
How do I take the medicine?
Warfarin
•
•
A small pill
You may have to take
more than 1 pill
Enoxaparin
•
A shot given in the fatty
part of your upper leg,
upper arm or stomach
area
•
A nurse will teach you
how to give the shots
We can give you a
cream that will numb
the spot where you give
the shot
•
How often do I give the
medicine?
•
One time each day
•
Two times each day,
once in the morning
and once at night
Do I give the same dose
every day?
•
•
What kind of follow up do I
need with this medicine?
•
The number of pills
may change depending
on your blood tests
You will need to go for
blood tests
The dose usually stays
the same unless your
weight changes
You may need to go for
blood tests once a
month
•
Does the medicine react with
any food or other medicine?
•
•
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These blood tests could
be as often as twice a
week to once each
month
Some medicines will
change how well
warfarin works
Sudden changes in the
foods you eat may
affect how well warfarin
works
•
•
Enoxaparin does not
react with other
medicines or foods
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Warfarin
What are the most common
side effects?
•
Who should not take this
medicine?
•
•
•
How much does it cost?
•
You may have an upset
stomach during the first
week
People who are or
could become pregnant
People who will need
surgery soon or often
People who cannot get
to the lab for blood
tests or keep track of
the amount of medicine
to take
Usually costs less than
$10 each month
Enoxaparin
•
•
•
•
•
•
You may have small
bruises where the shots
are given
People who recently
had surgery on their
spine or plan to do so
soon
People who are allergic
to heparin
People who cannot take
a shot twice each day
Usually costs much
more than Warfarin
Your nurse will help
you find out how much
the enoxaparin will cost
Does one medicine work better than the other?
When taken correctly, warfarin and enoxaparin keep blood clots from forming about the same in
most people.
Does one medicine have more risks than the other?
Abnormal bleeding is the most serious risk when taking warfarin or enoxaparin. About 2 in every
100 people taking warfarin or enoxaparin will have bleeding. The risk is higher when the medicine
dose is too high, so getting blood tests and taking the right amount is very important.
If you do not take the medicine or get blood tests as ordered, you are at a higher risk for bleeding or
forming another blood clot.
Enoxaparin has a rare risk (less than 1%) of heparin-induced thrombocytopenia (HIT). This is an
allergic type reaction that can cause blood clots to form in people who are allergic to heparin.
Other things to think about:
•
•
•
It is important that you do not skip any doses of medicine or blood tests, no matter which
medicine you choose.
Sometimes warfarin or enoxaparin does not work for some people. If this happens your
doctor may need to change to the other medicine.
If something changes or you change your mind about your choice of warfarin or enoxaparin,
it is ok. You can talk to your nurse or doctor about changing to the other medicine.
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Think about what matters most to you and what fits your lifestyle.
Please mark the boxes in the following questions based on what is most important to you:
1. I can
swallow pills every day.
I like this choice
I can give myself shots
Either is ok
I like this choice
2. I can go to a lab for blood tests:
Between 2 times each week
to once each month
I like this choice
Maybe once each
month
Either is ok
3. I can keep track of my
medicine dose and change
the amount
I like this choice
I prefer to take the
same amount of
medicine every day
Either is ok
4. I would be bothered
by small bruises where shots are given
I like this choice
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I like this choice
I like this choice
I would not be bothered
by small bruises where shots are
given
Either is ok
I like this choice
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5. I would need to eat
the same types of foods every day
I like this choice
I could eat any foods
Either is ok
6. I can remember to call
the nurse/doctor if my
my other medicines change
I like this choice
It would be hard to
remember to call the
doctor/nurse if my other
medicines change
Either is ok
7. Cost is important
in my decision
I like this choice
I like this choice
I like this choice
Cost is not important
in my decision
Either is ok
I like this choice
Let’s make sure you understand the basics:
1. Warfarin and enoxaparin both keep blood clots from forming:
_____ Yes
_____ No
2. I can skip a dose of either medication:
_____ Yes
_____ No
3. Which medicine comes as a pill?
__ Warfarin __ Enoxaparin
4. Which medicine is given by a shot?
__ Warfarin __ Enoxaparin
Do you understand what is different between warfarin and enoxaparin? ___ Yes
___ No
Write down any questions you have: ______________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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Are you ready to decide?
_____ I am ready to make a decision.
_____ I need to talk with someone else first: Who?_________________________________ (my
child, another family member, etc.)
_____ I need more information: From whom? _______________________________(doctor,
other health care providers, etc.)
What choice do you prefer?
___ Warfarin
___ Enoxaparin
How sure do you feel about your decision?
Very sure
Somewhat sure
Not Sure
How much did this decision aid help you make this decision?
Helped a lot
Helped somewhat
Did not help
Reference: Ansell, J. E., Oertel, L. B., & Wittkowsky, A. K. (Eds.). (2009). Managing oral anticoagulation therapy:
Clinical and operational guidelines (3rd Ed.). St. Louis, MO: Wolters Kluwer Health.
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