* Generic Name: warfarin sodium
* Brand Name: Coumadin
* What is warfarin (Coumadin, Jantoven)?
* What are the possible side effects of warfarin (Coumadin,
Jantoven)?
* What is the most important information I should know about
warfarin (Coumadin, Jantoven)?
* What should I discuss with my healthcare provider before taking
warfarin (Coumadin, Jantoven)?
* How should I take warfarin (Coumadin, Jantoven)?
* What happens if I miss a dose (Coumadin, Jantoven)?
* What happens if I overdose (Coumadin, Jantoven)?
* What should I avoid while taking warfarin (Coumadin, Jantoven)?
* What other drugs will affect warfarin (Coumadin, Jantoven)?
* Where can I get more information (Coumadin, Jantoven)?
What is warfarin (Coumadin, Jantoven)?
Warfarin is an anticoagulant (blood thinner). Warfarin reduces the
formation of blood clots.
Warfarin is used to treat or prevent blood clots in veins or arteries,
which can reduce the risk of stroke, heart attack, or other
serious conditions.
Warfarin may also be used for purposes not listed in this medication
guide.
What are the possible side effects of warfarin (Coumadin, Jantoven)?
Get emergency medical help if you have signs of an allergic reaction:
hives; difficult breathing; swelling of your face, lips, tongue, or
throat.
Warfarin increases your risk of bleeding, which can be severe or
life-threatening. Call your doctor at once if you have any signs of
bleeding such as:
* sudden headache, feeling very weak or dizzy;
* swelling, pain, unusual bruising;
* bleeding gums, nosebleeds;
* bleeding from wounds or needle injections that will not stop;
* heavy menstrual periods or abnormal vaginal bleeding;
* blood in your urine, bloody or tarry stools; or
* coughing up blood or vomit that looks like coffee
grounds.
Clots formed by warfarin may block normal blood flow, which could lead
to tissue death or amputation of the affected body part. Get
medical help at once if you have:
* pain, swelling, hot or cold feeling, skin changes, or discoloration
anywhere on your body; or
* sudden and severe leg or foot pain, foot ulcer, purple toes or
fingers.
Bleeding is the most common side effect of warfarin.
This is not a complete list of side effects and others may occur. Call
your doctor for medical advice about side effects. You may report side
effects to FDA at 1-800-FDA-1088.
What is the most important information I should know about warfarin
(Coumadin, Jantoven)?
You should not take warfarin if you are prone to bleeding because
of a medical condition, if you have an upcoming surgery, or if you need
a spinal tap or epidural. Do not take warfarin if you cannot
take it on time every day.
Warfarin increases your risk of severe or fatal bleeding, especially if
you have certain medical conditions, if you are 65 or older, or if you
have had a stroke, or bleeding in your stomach or intestines. Seek
emergency help if you have any bleeding that will not stop.
Call your doctor at once if you have other signs of bleeding such as:
swelling, pain, feeling very weak or dizzy, unusual bruising, bleeding
gums, nosebleeds, heavy menstrual periods or abnormal vaginal bleeding,
blood in your urine, bloody or tarry stools, coughing up blood or vomit
that looks like coffee grounds.
Many other drugs can increase your risk of bleeding when used with
warfarin. Tell your doctor about all medicines you have recently used.
Avoid making any changes in your diet without first talking to your
doctor. Some foods can make warfarin less effective.
Coumadin Patient Information including How Should I Take
Heart Disease:The No. 1 Killer in the U.S.
Heart Disease Slideshow Pictures
RxList
Medical Illustrations of the Heart Image Collection
RxList
Take the Heart Disease Quiz!
What should I discuss with my healthcare provider before taking warfarin
(Coumadin, Jantoven)?
You should not take warfarin if you are allergic to it, or if:
* you have very high blood pressure;
* you recently had or will have surgery on your brain, spine, or eye;
* you undergo a spinal tap or spinal anesthesia (epidural); or
* you cannot take warfarin on time every day.
You also should not take warfarin if you are are prone to bleeding
because of a medical condition, such as:
* a blood cell disorder (such as low red blood cells or low
platelets);
* ulcers or bleeding in your stomach, intestines, lungs, or
urinary tract;
* an aneurysm or bleeding in the brain; or
* an infection of the lining of your heart.
Do not take warfarin if you are pregnant, unless your doctor tells you
to. Warfarin can cause birth defects, but preventing blood clots
may outweigh any risks to the baby. If you are not pregnant, use
effective birth control to prevent pregnancy while taking warfarin and
for at least 1 month after your last dose. Tell your doctor right away
if you become pregnant.
Warfarin can make you bleed more easily, especially if you have ever
had:
* high blood pressure or serious heart disease;
* kidney disease;
* cancer or low blood cell counts;
* an accident or surgery;
* bleeding in your stomach or intestines;
* a stroke; or
* if you are 65 or older.
To make sure warfarin is safe for you, tell your doctor if you have
ever had:
* diabetes;
* congestive heart failure;
* liver disease, kidney disease (or if you are on dialysis);
* a hereditary clotting deficiency; or
* low blood platelets after receiving heparin.
It is not known whether warfarin passes into breast milk. Watch for
signs of bruising or bleeding in the baby if you take warfarin while
you are breast-feeding a baby.
How should I take warfarin (Coumadin, Jantoven)?
Follow all directions on your prescription label. Your doctor may
occasionally change your dose. Do not take warfarin in larger or
smaller amounts or for longer than your doctor tells you to.
Take warfarin at the same time every day, with or without food. Never
take a double dose.
Warfarin can make it easier for you to bleed. Seek emergency help if
you have any bleeding that will not stop.
You will need frequent "INR" or prothrombin time tests (to measure your
blood-clotting time and determine your warfarin dose). You must remain
under the care of a doctor while taking warfarin.
If you receive warfarin in a hospital, call or visit your doctor 3 to 7
days after you leave the hospital. Your INR will need to be tested at
that time. Do not miss any follow-up appointments.
Tell your doctor if you are sick with diarrhea, fever, chills, or flu
symptoms, or if your body weight changes.
You may need to stop taking warfarin 5 to 7 days before having any
surgery, dental work, or a medical procedure. Call your doctor for
instructions.
Wear a medical alert tag or carry an ID card stating that you take
warfarin. Any medical care provider who treats you should know that you
are taking this medicine.
Store at room temperature away from heat, moisture, and light.
Coumadin Patient Information including If I Miss a Dose
Heart Disease:The No. 1 Killer in the U.S.
Heart Disease Slideshow Pictures
RxList
Medical Illustrations of the Heart Image Collection
RxList
Take the Heart Disease Quiz!
What happens if I miss a dose (Coumadin, Jantoven)?
Take the missed dose as soon as you remember. Skip the missed dose if
it is almost time for your next scheduled dose. Do not take extra
medicine to make up the missed dose.
What happens if I overdose (Coumadin, Jantoven)?
Seek emergency medical attention or call the Poison Help line at
1-800-222-1222. An overdose can cause excessive bleeding.
What should I avoid while taking warfarin (Coumadin, Jantoven)?
Avoid activities that may increase your risk of bleeding or injury. Use
extra care to prevent bleeding while shaving or brushing your teeth.
You may still bleed more easily for several days after you stop taking
warfarin.
Avoid making any changes in your diet without first talking to your
doctor. Foods that are high in vitamin K (liver, leafy green
vegetables, or vegetable oils) can make warfarin less effective. If
these foods are part of your diet, eat a consistent amount on a
weekly basis.
Grapefruit juice, cranberry juice, noni juice, and
pomegranate juice may interact with warfarin and lead to unwanted
side effects. Avoid the use of these juice products while taking
warfarin.
Avoid drinking alcohol.
Ask your doctor before using any medicine for pain, arthritis,
fever, or swelling. This includes aspirin, ibuprofen (Advil,
Motrin), naproxen (Aleve), celecoxib (Celebrex),
diclofenac, indomethacin, meloxicam, and others. These
medicines may affect blood clotting and may also increase your risk of
stomach bleeding.
What other drugs will affect warfarin (Coumadin, Jantoven)?
Many drugs (including some over-the-counter medicines and herbal
products) can affect your INR and may increase the risk of bleeding if
you take them with warfarin. Not all possible drug interactions are
listed in this medication guide. It is very important to ask your
doctor and pharmacist before you start or stop using any other
medicine, especially:
* other medicines to prevent blood clots;
* an antibiotic or antifungal medicine;
* supplements that contain vitamin K; or
* herbal (botanical) products--coenzyme Q10, cranberry,
echinacea, garlic, ginkgo biloba, ginseng,
goldenseal, or St. John's wort.
This list is not complete and many other drugs can interact with
warfarin. This includes prescription and over-the-counter medicines,
vitamins, and herbal products. Give a list of all your medicines to any
healthcare provider who treats you.
Where can I get more information (Coumadin, Jantoven)?
Your pharmacist can provide more information about warfarin.
__________________________________________________________________
Remember, keep this and all other medicines out of the reach of
children, never share your medicines with others, and use this
medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by
Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete,
but no guarantee is made to that effect. Drug information contained
herein may be time sensitive. Multum information has been compiled for
use by healthcare practitioners and consumers in the United States and
therefore Multum does not warrant that uses outside of the United
States are appropriate, unless specifically indicated otherwise.
Multum's drug information does not endorse drugs, diagnose patients or
recommend therapy. Multum's drug information is an informational
resource designed to assist licensed healthcare practitioners in caring
for their patients and/or to serve consumers viewing this service as a
supplement to, and not a substitute for, the expertise, skill,
knowledge and judgment of healthcare practitioners. The absence of a
warning for a given drug or drug combination in no way should be
construed to indicate that the drug or drug combination is safe,
effective or appropriate for any given patient. Multum does not assume
any responsibility for any aspect of healthcare administered with the
aid of information Multum provides. The information contained herein is
not intended to cover all possible uses, directions, precautions,
warnings, drug interactions, allergic reactions, or adverse effects. If
you have questions about the drugs you are taking, check with your
doctor, nurse or pharmacist.
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