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Drug Guide    W   Warfarin

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This medication is used to treat blood clots and/or to prevent new clots from forming in your body. Preventing harmful blood clots helps to reduce the risk of a stroke or heart attack. Conditions that increase your risk of developing blood clots include a certain type of irregular heart rhythm (atrial fibrillation), heart valve replacement, and recent heart attack.Warfarin is commonly called a "blood thinner," but its more correct term is anticoagulant. It helps to keep blood flowing smoothly in your body by decreasing the amount of certain substances (clotting proteins) in your blood.

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 Warfarin images:

OverviewPhotosHow To UseSide EffectsPrecautionsMissed DoseDrug Interactions

This medication is used to treat blood clots and/or to prevent new clots from forming in your body. Preventing harmful blood clots helps to reduce the risk of a stroke or heart attack. Conditions that increase your risk of developing blood clots include a certain type of irregular heart rhythm (atrial fibrillation), heart valve replacement, and recent heart attack.Warfarin is commonly called a "blood thinner," but its more correct term is anticoagulant. It helps to keep blood flowing smoothly in your body by decreasing the amount of certain substances (clotting proteins) in your blood.
  • Do not share this medication with others.Laboratory and/or medical tests (e.g., blood tests such as PT/INR, complete blood count) should be performed periodically to monitor your progress or check for side effects.
  • Consult your doctor for more details.
  • It is important to eat a well-balanced diet while taking warfarin.
  • If you are trying to lose weight, check with your doctor before you try to go on a diet.

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

  • Symptoms of overdose may include: bloody/black/tarry stools, pink/dark urine, unusual or prolonged bleeding.

How To Use
  • Read the Medication Guide provided by your pharmacist before you start taking warfarin and each time you get a refill.
  • If you have any questions, consult your doctor or pharmacist.Take this medication by mouth with or without food, usually once a day or as directed by your doctor or other healthcare professional.
  • It is very important to take it exactly as prescribed.
  • Do not increase the dose, take it more frequently, or stop using it unless directed by your doctor.Use this medication regularly to get the most benefit from it.
  • To help you remember, take it at the same time each day.Some foods can affect how warfarin works in your blood and may affect your treatment and dose.
  • Avoid drinking cranberry juice or eating cranberry products unless your doctor directs you otherwise.
  • Talk with your doctor or pharmacist for more details.
  • (See also Drug Interactions section for other food interactions.)Dosage is based on your medical condition and response to treatment.
  • Your doctor or other healthcare provider will monitor you closely while you are taking this medication.
  • Therefore, laboratory tests will be performed periodically.

Side Effects
  • Nausea, loss of appetite, stomach/abdominal bloating, or cramps may occur.
  • If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects.
  • Many people using this medication do not have serious side effects.This medication can cause serious bleeding if it affects your blood clotting proteins too strongly (unusually high PT and INR lab results).
  • Even if your doctor stops your medication, this risk can continue for up to a week.
  • Tell your doctor immediately if you have any signs of serious bleeding, including: unusual pain/swelling/discomfort, severe headache, dizziness/fainting, unusual or persistent tiredness/weakness, bloody/black/tarry stools, unusual or easy bruising, prolonged bleeding from cuts or gums, persistent/frequent nosebleeds, unusually heavy/prolonged menstrual flow, pink/dark urine, coughing up blood, vomit that is bloody or looks like coffee grounds, fast/pounding heartbeat, chest pain, shortness of breath, difficulty swallowing.This drug may very rarely cause serious, possibly fatal skin/tissue damage.
  • Patients with certain blood conditions (protein C or S deficiency) may be at greater risk.
  • If left untreated, this effect can lead to severe tissue damage (necrosis, gangrene) that requires surgery or amputation.
  • Seek immediate medical attention if any of these very rare but serious side effects occur: painful/red patches, dark discoloration of any body part (e.g., toe, breast, abdomen), painful/tender toes, intense pain/burning feeling (e.g., breast, leg, foot), foot ulcer, back/side/chest pain, change in the amount of urine, muscle/joint pain, vision changes, confusion, slurred speech, weakness on one side of the body.Tell your doctor immediately if any of these unlikely but very serious side effects occur: persistent nausea, vomiting, severe stomach/abdominal pain, yellowing eyes/skin.A very serious allergic reaction to this drug is rare.
  • However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching, swelling, severe dizziness, trouble breathing.If you notice other effects not listed above, contact your doctor or pharmacist.

  • See also Warning section.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: a bleeding disorder (e.g., hemophilia), recent/current ulcer (e.g., stomach), certain heart diseases (pericarditis, pericardial effusion, bacterial endocarditis), certain brain conditions (cerebrovascular hemorrhage, cerebral aneurysm), recent or planned major surgery/procedure (e.g., brain/eye surgery, lumbar block anesthesia), uncontrolled severe blood pressure (malignant hypertension), certain pregnancy complications (eclampsia, preeclampsia, threatened abortion).Before using this medication, tell your doctor or pharmacist your medical history, especially of: alcohol use/abuse, mental/mood disorders (including memory problems), high blood pressure, heart disease (heart failure), high cholesterol/triglycerides, diabetes, kidney disease, liver disease, poor nutrition, stomach/intestinal disease (including absorption problems), vitamin C deficiency (scurvy), swelling of arms/legs (edema), cancer, tumor, radiation therapy, thyroid problems, catheter in your body (e.g., bladder), tissue damage (gangrene, necrosis), recent major injury or surgery, bleeding/blood-clotting problems (e.g., low vitamin K), blood disorders (e.g., anemia, polycythemia), blood vessel disease (e.g., arteriosclerosis, vasculitis), side effect with heparin treatment (heparin-induced thrombocytopenia), family member who did not respond to warfarin treatment.This medication may cause stomach bleeding.
  • Daily use of alcohol while using this medicine will increase your risk for stomach bleeding.
  • Limit or avoid alcoholic beverages.Avoid getting injections into the muscles.
  • If these injections must be given, limit injections to the arms to make it easier to check for bleeding and/or apply pressure bandages.If you have an illness or infection that causes fever, vomiting, or diarrhea for more than 2 days, contact your doctor immediately because these conditions can affect how warfarin works.It is important that all your doctors and dentists know you take warfarin.
  • Before having surgery or any medical/dental procedures, tell your doctor that you are using this medication.This medication can cause heavy bleeding.
  • To lower the chance of getting cut, bruised, or injured, use great caution with sharp objects like safety razors and nail cutters.
  • Use an electric razor when shaving and a soft toothbrush when brushing your teeth.
  • Avoid activities such as contact sports.If you fall or injure yourself, especially if you hit your head, call your doctor immediately.
  • Your doctor may need to check you.The Food & Drug Administration has stated that generic warfarin products are interchangeable.
  • However, consult your doctor or pharmacist before switching warfarin products.
  • Be careful not to take more than one medication that contains warfarin unless specifically directed by the doctor or healthcare provider who is monitoring your warfarin treatment.Caution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug.This medication is not recommended for use during pregnancy because of serious (possibly fatal) harm to an unborn baby.
  • Discuss reliable forms of birth control with your doctor.
  • If you become pregnant or think you may be pregnant, tell your doctor immediately.
  • If you are planning pregnancy, discuss a plan for managing your condition with your doctor before you become pregnant.
  • Your doctor may switch the type of medication you use during pregnancy.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.

Missed Dose
  • For the best possible benefit, do not miss any doses.
  • If you do miss a dose, take it as soon as you remember if it is on the same day.
  • If it is the next day, skip the missed dose and resume your usual dosing schedule.
  • Do not double the dose to catch up because this could increase your risk for bleeding.
  • Keep a record of missed doses to give to your doctor or pharmacist.
  • Contact your doctor or pharmacist if you miss 2 or more doses in a row.

Drug Interactions
  • Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them.
  • Do not start, stop, or change the dosage of any drug, vitamin, or herbal product without checking with your doctor or pharmacist first.Warfarin interacts with many prescription, nonprescription, vitamin, and herbal products.
  • This includes medications that are applied to the skin or inside the vagina or rectum.
  • The following interactions listed do not contain all possible drug interactions.
  • The interactions with warfarin usually result in an increase or decrease in the "blood-thinning" (anticoagulant) effect.
  • Patients taking warfarin should be closely monitored to prevent serious bleeding or clotting problems.This drug should not be used with the following medication because a very serious interaction may occur: mifepristone.If you are currently taking the medication listed above, tell your doctor or pharmacist before starting warfarin.Aspirin and aspirin-like drugs (salicylates) and nonsteroidal anti-inflammatory drugs (NSAIDs such as ibuprofen, naproxen, celecoxib) may have effects similar to warfarin.
  • These drugs may increase the risk of bleeding problems if taken during treatment with warfarin.
  • Carefully check all prescription/nonprescription product labels (including drugs applied to the skin such as pain-relieving creams) since they may contain NSAIDs or salicylates.
  • Low-dose aspirin and related drugs (e.g., clopidogrel, ticlopidine) should be continued if prescribed by your doctor for specific medical reasons such as heart attack or stroke prevention.
  • Ask your doctor or pharmacist about using these products safely.Many herbal medications have "blood-thinning" or "blood-clotting" effects, and some may directly affect warfarin.
  • Tell your doctor before taking any herbal medications, especially bromelains, coenzyme Q10, danshen, dong quai, fenugreek, garlic, ginkgo biloba, ginseng, goldenseal, St.
  • Johns wort, among others.While taking warfarin, it is important to eat a balanced, consistent diet.
  • Avoid sudden large increases or decreases in your intake of foods high in vitamin K (e.g., liver, broccoli, cauliflower, cabbage, Brussels sprouts, kale, spinach and other green leafy vegetables, green tea, certain vitamin supplements) because doing so may change the effect of this medication.This medication can affect the results of a certain lab test (theophylline level).
  • Make sure laboratory personnel and all your doctors know you use this drug.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgement of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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