$Unique_ID{BRK03379} $Pretitle{} $Title{warfarin} $Subject{Coumadin DuPont Panwarfin Abbott Sofarin Lemmon sodium Anticoagulant warfarin prevent blood clot formation liver clotting} $Volume{} $Log{ Coumadin*0337901.scf} Copyright (C) 1993 Publications International, Ltd. warfarin ------------------------------------------------------------------------------ BRAND NAMES (Manufacturers) Coumadin (DuPont) Panwarfin (Abbott) Sofarin (Lemmon) warfarin sodium (various manufacturers) TYPE OF DRUG Anticoagulant INGREDIENT warfarin DOSAGE FORM Tablets (2 mg, 2.5 mg, 5 mg, 7.5 mg, and 10 mg) STORAGE Warfarin should be stored at room temperature in a tightly closed, light-resistant container. USES Warfarin is used to prevent blood clot formation. It acts by decreasing the production of blood clotting substances by the liver. TREATMENT You can take warfarin with a full glass of water. In order to become accustomed to taking this medication, try to take it at the same time each day. If you miss a dose of this medication, take the missed dose as soon as possible, unless it is almost time for the next dose. In that case, do not take the missed dose at all; just return to your regular dosing schedule. Do not double the next dose. If you miss more than two doses in a row of this medication, contact your doctor. SIDE EFFECTS Minor. Blurred vision, cramps, decreased appetite, diarrhea, or nausea. These side effects should disappear as your body adjusts to the medication. Warfarin may produce a red-orange discoloration of urine. Major. Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about bloody or black, tarry stools; blood in sputum; fever; heavy bleeding from cuts; internal bleeding (signs of internal bleeding include abdominal pain or swelling and vomiting of blood or material that resembles coffee grounds); loss of hair; mouth sores; nosebleeds; nausea; rash; red urine; severe bruising; severe headache; swelling of joints; unusually heavy menstrual bleeding; or yellowing of the eyes or skin. INTERACTIONS Warfarin interacts with several other types of drugs: 1. Alcohol, allopurinol, amiodarone, anabolic steroids, antibiotics, chloral hydrate, chloramphenicol, chlorpropamide, cimetidine, clofibrate, danazol, disulfiram, erythromycin, glucagon, isoniazid, ketoconazole, methyldopa, methylphenidate, metronidazole, monoamine oxidase (MAO) inhibitors, nalidixic acid, phenylbutazone, propoxyphene, quinidine, quinine, salicylates, sulfamethoxazole and trimethoprim combination, sulfinpyrazone, sulfonamides, sulindac, tetracycline, thyroid hormones, and tolbutamide can increase the effects of warfarin, which can be dangerous. 2. Azathioprine, barbiturates, carbamazepine, cholestyramine, colestipol, estrogens, ethchlorvynol, griseofulvin, oral contraceptives (birth control pills), phenytoin, propylthiouracil, rifampin, sucralfate, and vitamin K can decrease the effectiveness of warfarin. 3. Adrenocorticosteroids (cortisone-like medications), anticancer drugs, aspirin, diflunisal, dipyridamole, fenoprofen, ibuprofen, indomethacin, oxyphenbutazone, phenylbutazone, potassium, quinidine, quinine, and salicylates can increase the bleeding complications of warfarin. 4. Warfarin can increase the side effects of oral antidiabetic agents and phenytoin. 5. Diuretics (water pills) may either increase the effects or decrease the effectiveness of warfarin. Ask your doctor about concurrent use of diuretics and warfarin. Before starting to take warfarin, BE SURE TO TELL YOUR DOCTOR about any medications (both prescription and nonprescription) you are currently taking, especially any of those listed above. WARNINGS * Tell your doctor about unusual or allergic reactions you have had to any medications, especially to warfarin. * Before starting to take this medication, BE SURE TO TELL YOUR DOCTOR if you now have or if you have ever had any condition for which bleeding is an added risk--an aneurysm, blood disorders, cancer, diabetes mellitus, congestive heart failure, edema, endocarditis, high blood pressure, indwelling catheters, intestinal infections, kidney or liver disease, malnutrition, menstrual difficulties, pericarditis, surgery, thyroid disease, tuberculosis, ulcers, vasculitis, or wounds and injuries. * Before having surgery or any other medical or dental treatment, BE SURE TO TELL YOUR DOCTOR OR DENTIST THAT YOU ARE TAKING WARFARIN. * Do not take any aspirin-containing products or any over-the-counter products while you are on warfarin, unless you first check with your doctor or pharmacist. Aspirin can increase the risk of bleeding complications from warfarin. * Avoid any activity, such as a contact sport, that might lead to physical injury. Tell your doctor about any fall or blow that occurs. Warfarin can cause HEAVY bleeding from cuts. * Use an electric razor while shaving to reduce the risk of cutting yourself, and be especially careful while brushing your teeth. * Since factors such as travel, diet, the environment, and your health can affect your body's response to warfarin, your dosage level should be carefully monitored. * Do not stop taking warfarin unless you first consult your doctor. If you stop taking this drug abruptly, you may experience blood clotting. Your doctor may, therefore, want to reduce your dosage gradually. * Do not change brands of this medication without consulting your doctor. * Some of these products contain the color additive FD&C Yellow No. 5 (tartrazine), which can cause allergic-type reactions in certain susceptible individuals. * Be sure to tell your doctor if you are pregnant. Warfarin has been associated with birth defects and bleeding complications in fetuses. Also, tell your doctor if you are breast-feeding an infant. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.