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Warfarin (Coumadin)


Uses

 

Warfarin(Coumadin) decreases the body’s production of vitamin K, which stops the production of a large variety of clotting factors and prevents blood clot formation. It used to treat conditions such as atrial fibrillation, deep venous thrombosis, pulmonary embolisms, and others.

 

 

How to Use

 

Take this medication by mouth with water, it can be taken with or without food.

 

Take this medication at the same time every day.

 

Take it exactly as directed, do not take it more than directed.

 

If you miss a dose, take it as soon as you can. If it is already almost time for your next dose, take only that next dose. Do not double up on any dose. Contact your healthcare provider if you miss a dose of this medication.

 

 

Important Information

 

Do not stop taking this medication suddenly or without consulting with your healthcare provider. Stopping this medication suddenly increases your chance of developing a blood clot. Ensure that your refill is ready and in your possession before running out of the medicine.

 

If your doctor tells you over the phone to change the dose, be sure to write down the dose along with the date of the new instructions. Read the dose and instructions back to the doctor to ensure accuracy. If you are informed that you should stop taking the medicine until your upcoming blood test, be sure that after the blood test you contact your doctor to find out when to continue the medication regimen.

 

Contact a healthcare provider if you develop signs and symptoms of bleeding such as: Black, tarry or bloody stools, dark brown or red urine, spitting up blood or coffee ground colored material, red spots on the skin surface, bruising or bleeding of the eyes, nose, gums, or skin.

 

 

Be sure that your prescribing doctor is aware if you have any of the the following conditions before taking this medication

 

Alcoholism, anemia, blood disorders, diabetes, cancer, heart diseases, high blood pressure, history of gastrointestinal bleeding, history of brain injuries or strokes, brain diseases, protein C deficiency, protein S deficiency, dementia, psychosis, any recent injuries, recent surgery, planned future surgeries, history of allergic reactions, pregnancy, breastfeeding, trying to become pregnant.

 

 

Side effects that should be immediately reported to your healthcare provider

 

Allergic reactionx(hives, itching, rashes, swelling of the face or mouth), trouble breathing, back pain, chills, dizziness, fever, vaginal bleeding, heavy menstrual bleeding, toes that are painful, blue or purple in color, painful or prolonged erection, excessive fatigue, unusually weak or tired, yellowing of the skin or eyes, stomach pain, signs and symptoms of bleeding such as: Black, tarry or bloody stools, dark brown or red urine, spitting up blood or coffee ground colored material, red spots on the skin surface, bruising or bleeding of the eyes, nose, gums, or skin.

 

 

Other Side Effects

 

Hair loss, diarrhea.

 

 

Adult Dose

 

The dose for warfarin is unique for each patient and is individualized based on the patient’s INR. The target INR is typically between 2 and 3.

 

 

Atrial Fibrillation, Myocardial Reinfarction Prophylaxis, Percutaneous Transluminal Coronary Angioplasty, Pulmonary Embolism, Pulmonary Embolism Prophylaxis, Venous Thromboembolism

 

Between 2mg and 5mg by mouth or intravenously as a starting dose. The dose is then titrated based on the INR. The usual maintenance dose is between 2mg and 10mg.

 

 

Sources

 

1. Coumadin (warfarin) [package insert]]. Princeton, NJ: Bristol-Meyers Squibb; 2015.

 

2. Jantoven [package insert]. Minneapolis, MN: Upsher-Smith Laboratories; 2007.

 

3. Warfarin Sodium Tablets [package insert]. Hawthorne, NY: Taro Pharmaceuticals; December 2006.

 

4. COUMADIN(R) oral tablets, intravenous injection, warfarin sodium oral tablets, intravenous injection[package insert]. Princeton, NJ: Bristol-Myers Squibb Company; 2010.

 

5. Smith SC, Alley J, Blair SN, et al. AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update. Circulation 2006;113:2363-72.


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