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Warfarin is the generic form of the brand-name drugs Coumadin and Jantoven, prescribed to treat blood clots.
Blood clots can occur if you have conditions like deep vein thrombosis (DVT) or pulmonary embolus (PE).
Other conditions that might increase your risk of developing blood clots are an irregular heart rhythm known as atrial fibrillation, a recent heart attack, heart valve replacement, or surgeries like a hip or knee replacement.
Warfarin is also used to prevent new blood clots from forming, helping to reduce your risk of stroke or heart attack.
The anticoagulant is designed to keep blood flowing smoothly in your body by decreasing the amount of clotting proteins present in your blood.
First approved by the Food and Drug Administration (FDA) in 1954, warfarin is available in different strength tablets and injections.
According to the FDA, about two million people in the United States take warfarin to prevent blood clots, heart attack, and/or strokes.
Warfarin Warnings The FDA has issued a black-box warning for warfarin because the drug can lead to severe bleeding that could be fatal.
The risk of bleeding is more likely when you first begin taking the drug or if you are using a higher dose.
One additional concern with warfarin is that it can be difficult for your doctor to determine the correct dosage, because the right dose will vary depending on your age, diet, and use of other drugs.
In 2007, the FDA updated the labeling of warfarin to explain that a person’s genetic makeup might influence how he/she responds to the drug.
Anyone who has a bleeding disorder should not use warfarin.
In addition, you should not use warfarin if you have blood in your urine or stools, bleeding in your brain or stomach, or an infection in the lining of your heart.
You should avoid using warfarin if you need a spinal tap or epidural, if you had a recent surgery, or are anticipating surgery.
During the time you are taking this drug, you’ll need to keep track of the time it takes your blood to clot by undergoing occasional blood tests.
If you are planning to have any surgery, including a dental procedure, make sure your doctor/dentist is aware that you are using warfarin as well as all the other drugs and products you are taking.
You should also avoid getting injections in your muscles as much as possible.
If you must get one, use your arm so that any potential bleeding will be easy to detect.
In the event you develop an illness that results in vomiting, diarrhea or fever and it lasts longer than two days, let your doctor know right away since this could impact how the drug works.
Pregnancy and Warfarin Warfarin has been linked to miscarriage, birth defects, and other abnormalities, and the risks of taking warfarin during pregnancy clearly outweigh the benefits.
Don’t take this medication if you are pregnant unless your doctor has advised you to do so.
There are no studies showing warfarin is present in the breast milk of women using the drug, though the manufacturer has recommended that caution be used when women who are breastfeeding used warfarin.
Using warfarin in children requires close monitoring.
BasicDescription Back to Top Warfarin Side Effects Common Side Effects of Warfarin: Bloating/gas An altered sense of taste Nausea, vomiting, and mild stomach pain Warfarin is known to cause bleeding, which may be serious or fatal.
Certain groups of people are at a higher risk for bleeding such as those 65 and older as well as those who have high blood pressure or a history of stroke or mini-stroke known as TIA (transient ischemic attack), and/or stomach or intestinal bleeding.
You might also face an increased risk of bleeding if you have serious heart disease, a low blood count, cancer, kidney problems, are in an accident, or have surgery.
Taking medication that contains heparin or other drugs used to prevent blood clots as well as non-steroidal anti-inflammatory drugs (NSAIDs) also makes bleeding more likely.
Warfarin and Skin Necrosis It’s important to contact your doctor right away if you notice signs of dying skin or skin necrosis, as well as gangrene.
These conditions have been known to happen soon after people start using warfarin.
If you have pain, color or temperature change in any area of your body, seek medical help immediately to prevent amputation.
Call your physician immediately if you have pain in your toes or they look purple or dark in color.
If you have any unusual bleeding, pain, swelling, or discomfort as well as headaches, dizziness, or weakness, seek care right away.
Other signs of a potentially serious problem include coughing up blood or vomiting something that looks like coffee grounds, unusual bruising, nose or gum bleeds, menstrual or vaginal bleeding that is heavier than normal, a cut that takes a long time to stop bleeding, pink or brown urine, and red or black stools.
Emergency help is also required if you have an allergic reaction.
Symptoms range from hives or difficulty breathing to swelling of your face, lips, tongue, or throat.
Back to Top Warfarin Interactions Before using this medicine it’s important to tell your doctor about all your previous health conditions as well as all the medications, including all prescription, non-prescription, illegal, recreational, herbal, nutritional, or dietary drugs that you are taking.
Prescriptions drugs of concern when taking warfarin include: Ciprofloxacin (Cipro) Erythromycin (Erythrocin) Clarithromycin (Biaxin) Metronidazole (Flagyl) Sulfamethoxazole/ Trimethoprim (Septra or Bactrim ) Fluconazole (Diflucan) Amiodarone (Cordarone) Carbamazapine ( Tegretol or Carbatrol) Phenytoin ( Dilantin ) Phenobarbital The following over-the-counter (OTC) products may also interact with warfarin: Acetaminophen ( Tylenol ) Aspirin Ibuprofen (Motrin, Advil) Naproxen (Aleve) Cimetidine (Tagamet) Omeprazole ( Prilosec ) In addition, certain herbal supplements like garlic, alfalfa, anise, asafetida, clove oil, dong quai, feverfew, ginkgo biloba, ginseng, St.
John’s wort, and co-enzyme Q10, may also impact warfarin’s effectiveness.
Warfarin and Diet While using warfarin, it’s important that you eat a healthy and balanced diet.
However, avoid adding large amounts of vegetables or drinks that contain vitamin K to your diet, since too much vitamin K can reduce the effectiveness of warfarin.
The following are rich in vitamin K: Spinach Green tea Chard Kale Brussels sprouts Parsley Collard greens Mustard greens Some vegetable oils also contain large amounts of vitamin K, so it’s important that you read all labels.
Warfarin and Alcohol Warfarin might cause stomach bleeding, a risk that could be increased if you drink alcohol daily.
Alcohol might also affect the way warfarin works so it’s a good idea to limit your intake of alcoholic drinks.
Back to Top Warfarin Dosage It’s important that you take warfarin at the same time each day.
You should not go on this medicine if you cannot do that.
Many people begin with a dose of 5 milligrams (mg) per day, but this varies.
Your doctor will determine the exact dose and administration that is right for you.
Each person is different so don’t take it upon yourself to adjust the dosage without speaking to your doctor.
Warfarin Overdose Taking too much warfarin can produce serious consequences.
If you think you have overdosed, get to the emergency room right away or call a poison control center at 1-800-222-1222.
Signs of an overdose range from bloody, black or tarry stools to pink or dark urine and unusual or prolonged bleeding.
Missed Dose of Warfarin If you forget to take your medication, it’s best to contact your doctor to determine how to proceed.
If it’s the same day, you may still be able to take it.
However, never take a double dose of warfarin to make up for a missed dose.
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