$Unique_ID{BRK02184}
$Pretitle{}
$Title{WARFARIN}
$Subject{Coumadin (DuPont)
Panwarfin (Abbott)
Sofarin (Lemmon)
warfarin sodium (various manufacturers)}
$Volume{}
$Log{
Coumadin*0218401.scf}

Copyright (C) 1991 Publications International, Ltd.


WARFARIN
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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, tolbutamide, and
triclofos can increase the effects of warfarin, which can be dangerous.
     2. Azathioprine, barbiturates, carbamazepine, cholestyramine, colestipol,
estrogens, ethchlorvynol, glutethimide, 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 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 riskan 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.
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 for
shaving to reduce the risk of cutting yourself, and be 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 (rash, shortness of
breath, fainting) 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.  Small amounts of
warfarin pass into breast milk.

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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.
