Coumadin (Warfarin)

Medicine Uses

Warfarin is an anticoagulant (blood thinner). It is prescribed to: Prevent and/or treat a blood clot that has formed within a blood vessel or in the lungs. Prevent and/or treat blood clots associated with certain heart conditions or replacement of a heart valve. Aid in the prevention of blood clots that may form in blood vessels anywhere in the body after a heart attack. Reduce the risk of death, another heart attack, or stroke after a heart attack.

How to use

Most patients are satisfactorily maintained at a dose of 2 to 10 mg daily. Flexibility of dosage is provided by breaking scored tablets in half. Warfarin may be taken with or without food. Since Coumadin is metabolized by the liver and excreted by the kidneys, dosages need to be lowered in patients with liver and kidney dysfunction. Frequent blood tests are performed to measure blood clotting time (protime) during Warfarin treatment.

Missed Dose

The anticoagulant effect of warfarin persists beyond 24 hours. If the patient forgets to take the prescribed dose of warfarin at the scheduled time, the dose should be taken as soon as possible on the same day. The patient should not take the missed dose by doubling the daily dose to make up for missed doses, but should refer back to his or her physician.

Storage

Store at room temperature between 59 and 86 degrees F (between 15 and 30 degrees C) away from moisture and sunlight. Do not store in the bathroom. Keep away from children and pets.

Warnings/Precautions

Before taking warfarin, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: blood disorders (e.g., hemophilia), bleeding conditions (e.g., active ulcers), uncontrolled severe high blood pressure (malignant hypertension), recent or planned surgery, received certain procedures (e.g., spinal cord injections, major anesthesia). Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, alcohol abuse, tissue damage (e.g., gangrene, necrosis), trauma, high blood pressure, severe diabetes, congestive heart failure, cancer, collagen vascular disease (e.g., lupus, polyarteritis), radiation therapy, underactive or overactive thyroid, poor nutrition, intestinal absorption problems, low blood levels of vitamin K, swelling of the arms/legs (edema), high cholesterol/fat blood levels, catheters in your body (e.g., urinary or intravenous type), side effects with heparin treatment (heparin-induced thrombocytopenia), family members who did not respond to warfarin treatment, conditions that make it difficult to follow a warfarin treatment plan (e.g., dementia, psychosis). Avoid alcohol while taking this drug because it may increase the risk of stomach bleeding. Avoid getting injections into the muscles (intramuscular-IM). If they must be given, limit injections to the arms. The FDA has stated that generic warfarin products are interchangeable. However, consult your doctor and pharmacist before switching warfarin products. If you have an illness or infection that causes vomiting, diarrhea or fever for more than a few days, contact your doctor immediately because these conditions can affect how well this drug works. This medication can cause heavy bleeding. Be extra careful to avoid injuries (e.g., avoid contact sports). Use an electric razor when shaving and a soft toothbrush when brushing your teeth. It is important that all your doctors and dentists know you take warfarin. Caution is advised when using this drug in the elderly because they may be more sensitive to its effects. This medication must not be used during pregnancy because of possible fetal harm and birth defects. Discuss reliable forms of birth control with your doctor. If you become pregnant or think you may be pregnant, inform your doctor immediately. You will be switched over to another anticoagulant (e.g., heparin-type) during pregnancy. Consult your doctor for more information. This medication does not pass into breast milk. While there have been no reports of harm to nursing infants, consult your doctor before breast-feeding.

Possible Side Effects

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking warfarin. More common side effects may include: Hemorrhage: Signs of severe bleeding resulting in the loss of large amounts of blood depend upon the location and extent of bleeding. Symptoms include: chest, abdomen, joint, muscle, or other pain; difficult breathing or swallowing; dizziness; headache; low blood pressure; numbness and tingling; paralysis; shortness of breath; unexplained shock; unexplained swelling; weakness Warfarin can interact with a very wide variety of drugs, both prescription and over-the-counter. Check with your doctor before taking ANY other medication or vitamin product. Be extremely cautious, too, about taking any herbal remedies and supplements. A wide assortment of herbal products--including St. John's Wort, coenzyme Q10, bromelains, dan-shen, dong quai, garlic, and ginkgo biloba–are known to interact with Coumadin or otherwise affect coagulation.

More Information

The anticoagulant effect of warfarin persists beyond 24 hours. If the patient forgets to take the prescribed dose of warfarin at the scheduled time, the dose should be taken as soon as possible on the same day. The patient should not take the missed dose by doubling the daily dose to make up for missed doses, but should refer back to his or her physician.

Disclaimer

This is only general information, it does not cover all directions, drug integrations or precautions. You should not rely on it for any purpose, it does not contain any specific instructions for a particular patient. The data is general and shouldn't be trusted for every aim.