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Generic Name: Warfarin Tablets (WAR-far-in)
Brand Name: Coumadin

Warfarin is used for:

Treating and preventing harmful clots that may occur in the veins (venous thrombosis), in the lungs (pulmonary embolism), with a type of abnormal heartbeat (atrial fibrillation), or following a heart valve replacement. Warfarin is also used to reduce the risk of stroke and other problems in patients who have had a heart attack. It may also be used to treat or prevent other conditions as determined by your doctor.

Warfarin is an anticoagulant. It works by blocking the synthesis of certain clotting factors. Without these clotting factors, blood clots are unable to form.

Do NOT use Warfarin if:

  • you are allergic to any ingredient in Warfarin
  • you are planning or have recently had major surgery, surgery of the eyes or nervous system, spinal puncture, or spinal anesthesia
  • you have severe or untreated high blood pressure, inflammation or infection of your heart, certain problems with your arteries or veins (such as an aneurysm), blood disorders, or bleeding problems (such as hemophilia)
  • you are unsupervised and unable to follow close directions and routinely keep doctor and lab appointments
  • you have preeclampsia, eclampsia, an incomplete abortion, or are pregnant
  • you have leukemia, red blood cell overproduction, or a reduced platelet count
  • you drink herbal teas or take mifepristone

Contact your doctor or health care provider right away if any of these apply to you.

Before using Warfarin :

Some medical conditions may interact with Warfarin . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines or other substances
  • if you have a stomach, lung, or urinary tract lesion, an ulcer, tuberculosis, a catheter, an IUD, recently given birth, a fever, allergies, intestinal problems, liver problems, an infection, high blood pressure, arthritis, a mood disorder, diabetes, an infection of the heart, inflammation of the blood vessels, cancer, if you are an alcoholic, or if you have suffered trauma
  • if you have a vitamin C, vitamin K, or protein C deficiency

Some MEDICINES MAY INTERACT with Warfarin . Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Many prescription and nonprescription medicines (eg, used for infections, inflammation, aches and pains, high blood pressure, high cholesterol, seizures, and other conditions), and herbs found in multivitamin products, herbal teas and dietary supplements (eg, CoQ10, garlic, ginseng, ginkgo, St. John"s wort, and others) may interact with Warfarin which may increase the risk of serious bleeding or the risk of serious blood clots.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Warfarin may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Warfarin :

Use Warfarin as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Warfarin should consistently be taken either with food or on an empty stomach at each dose.
  • Avoid eating large amounts of grapefruit or drinking grapefruit or cranberry juice while taking Warfarin .
  • Take Warfarin at the same time each day to help you remember to take it.
  • Do not miss any doses of Warfarin . If you miss a dose of Warfarin , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Warfarin .

Important safety information:

  • Warfarin may cause dizziness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Warfarin . Using Warfarin alone, with certain other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks.
  • Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Warfarin .
  • Warfarin reduces blood clotting. To prevent bleeding, avoid any sports or other activities that may expose you to a risk of bruising or serious injury.
  • Do not change your eating habits, alcohol consumption, or activity level without checking with your doctor. A change in your diet, alcohol consumption, or activity level may lead to a change in the effects of your medicine.
  • Eat a normal, balanced diet. Avoid drastic changes in dietary habits, especially when eating leafy, green vegetables or liver, because they contain vitamin K, which affects how Warfarin works.
  • Do not change brands of Warfarin without talking to your doctor or pharmacist.
  • If you are already taking aspirin for a heart or other condition, talk with your doctor about whether or not you should continue taking it with Warfarin .
  • While you are using Warfarin , brush your teeth carefully with a soft toothbrush, floss your teeth gently, and use caution when shaving.
  • Carry an identification card at all times that says you are taking Warfarin .
  • Do not become overheated in hot weather as this may change the effect of Warfarin .
  • LAB TESTS, including blood clotting tests, may be performed to monitor your progress or to check for side effects. Be sure to keep all doctor and lab appointments.
  • Use Warfarin with caution in the ELDERLY because they may be more sensitive to the effects of the medicine.
  • Warfarin is not recommended for use in CHILDREN younger than 3 months of age. Safety and effectiveness in this age group have not been confirmed.
  • Do not use Warfarin if you are pregnant. If you suspect that you could be pregnant, contact your doctor immediately. It is unknown if Warfarin is excreted in breast milk. If you are or will be breast-feeding while you are using Warfarin , check with your doctor or pharmacist to discuss the risks to your baby.

Possible side effects of Warfarin :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Abnormal skin sensations; changes in taste; chills; diarrhea; difficulty swallowing; dizziness; feeling cold; fever; general body discomfort; hair loss; itching; lack of energy; nausea; pale skin; skin inflammation; stomach pain, cramps, or bloating; tiredness; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blood in the urine; dizziness; excessive bleeding from cuts; excessive bleeding from gums when brushing teeth; headache; increased menstrual bleeding or unusual bleeding from vagina; muscle pain; nosebleeds; numbness; penis gangrene; purple toes; red or black, tarry stools; red or dark brown urine; shortness of breath; sores or ulcers on skin; stomach, chest, joint or other pain; sudden or severe pain in your legs, feet, or toes; unexplained swelling; unusual bruising; unusual pain, swelling, or discomfort; weakness; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include: abnormal bleeding or bruising; blood in vomit urine, or stools.

Proper storage of Warfarin :

Store at controlled room temperature between 59 and 86 degrees F (15 and 30 degrees C) in a tightly-closed container. Keep away from heat, moisture, and light. Do not store in the bathroom. Keep Warfarin out of the reach of children and away from pets.

General information:

  • If you have any questions about Warfarin , please talk with your doctor, pharmacist, or other health care provider.
  • Warfarin is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Warfarin . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: November 1, 2006
Database Edition
Copyright © 2006 Wolters Kluwer Health, Inc.

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