June 2025: What You Need to Know About Prometrium and Coumadin

This month we published two practical guides: one on Prometrium (a progesterone drug) and one on Coumadin (warfarin). Both articles focus on real-world use — who benefits, common side effects, dosing basics, and simple safety moves you can use right away. If you take either medication or care for someone who does, these are the main points to remember.

Prometrium (progesterone): uses and what to expect

Prometrium is a micronized progesterone often used for luteal support in fertility treatments, to protect the uterine lining during hormone therapy, and to treat menstrual irregularities. Typical oral dosing is often 100–200 mg at bedtime, though vaginal forms exist and may be prescribed for fertility support. Expect side effects like drowsiness, breast tenderness, bloating, and mood changes — drowsiness is common, so avoid driving until you know how it affects you.

Practical tips: take Prometrium with food to reduce stomach upset and follow your prescriber’s timing closely if it’s for fertility — timing can matter. If you’re using it with estrogen, your doctor may prescribe it to reduce the risk of endometrial hyperplasia. Tell your provider about liver disease, allergies, or if you’re breastfeeding. If you experience severe mood swings, yellowing of the skin, or signs of a serious reaction, contact medical help quickly.

Coumadin (warfarin): safe blood thinning and common traps

Coumadin (warfarin) is a long-standing oral anticoagulant. It prevents clots but requires regular monitoring via INR testing to hit the right balance between preventing clots and avoiding bleeding. Common target INR ranges are 2.0–3.0 for many conditions; other conditions need different targets, so follow your clinic’s plan.

Watch for food and drug interactions. Leafy greens and other vitamin K–rich foods can lower warfarin’s effect, while antibiotics, antifungals, and some pain meds can raise bleeding risk. Keep your vitamin K intake steady instead of cutting it out entirely. Never start or stop meds, herbal supplements, or large dietary changes without checking your INR plan.

Signs of trouble include unusual bruising, blood in stool or urine, nosebleeds that won’t stop, or sudden severe headaches. If those occur, seek help immediately. Practical safety steps: carry ID that says you’re on warfarin, schedule regular INR checks, tell every provider and dentist you’re taking it, and avoid NSAIDs when possible. Newer direct oral anticoagulants are preferred for many patients now, but warfarin is still the right choice for mechanical heart valves, some severe kidney problems, and certain other conditions.

Both articles give clear, actionable advice: follow dosing, monitor for side effects, keep good communication with your healthcare team, and ask questions when your treatment or diet changes. If you missed the full posts, check them for dosing tables, symptom checklists, and sample questions to bring to your next appointment.