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Warfarin Consumer Information

WARFARIN

Generic Name: warfarin (WAR far in)

Brand Names: Coumadin

What is the most important information I should know about warfarin?

• Never take a double dose of this medication.
• Do not take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil, Nuprin, others), ketoprofen (Orudis, Orudis KT, Oruvail), naproxen (Naprosyn, Aleve, Anaprox), and others while taking warfarin, except under the direction of your doctor. These medicines increase the risk of bleeding.
• Avoid sudden changes in your diet. Vitamin K decreases the effects of warfarin. Large amounts of vitamin K are found in foods such as liver, broccoli, brussels sprouts, and green leafy vegetables (e.g., spinach, Swiss chard, coriander, collards, cabbage). Do not change the amount of these foods in your diet without first talking to your doctor.
• It will be necessary to regularly monitor your therapy with a blood test called a "PT" or an "INR." These tests help to determine the amount of warfarin that you need to take.
• Contact your doctor if you experience any unusual bruises or heavily bleeding wounds, diarrhea, infection, or fever during treatment with warfarin.

What is warfarin?

• Warfarin is an anticoagulant (blood thinner).
• Warfarin reduces the formation of blood clots, which is important in the prevention of heart attacks, strokes, and blockage of major veins and arteries.
• Warfarin may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking warfarin?

• Do not take warfarin if you:
• recently had surgery;
• have a stomach ulcer or bleeding in the stomach;
• have had a certain type of stroke caused by bleeding in the brain;
• have had an aneurysm;
• recently had a spinal puncture or lumbar block anesthesia; or
• have bacterial endocarditis (infection of the heart), pericarditis (swelling of tissue around the heart), or pericardial effusion (build-up of fluid around the heart).
• Before taking warfarin, tell your doctor if you:
• have kidney disease;
• have liver disease;
• have high blood pressure;
• have a hereditary protein C or protein S deficiency;
• are diabetic;
• have polycythemia vera;
• have vasculitis;
• have congestive heart failure;
• have a collagen vascular disorder such as systemic lupus erythematosus;
• have thyroid disease;
• have high cholesterol;
• have cancer;
• have a vitamin K deficiency;
• are considering having surgery; or
• are taking antibiotics to treat an infection.
• You may not be able to take warfarin, or you may need a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
• Warfarin is in the FDA pregnancy category X. This means that warfarin is known to cause birth defects in an unborn baby and must not be taken during pregnancy. Do not take warfarin if you are pregnant or could become pregnant during treatment. Consult your doctor immediately if you become pregnant while taking warfarin.
• Warfarin has not been detected in human breast milk. Talk to your doctor before taking warfarin if you are breast-feeding a baby.

How should I take warfarin?

• Take warfarin exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take each dose with a full glass of water.
• It is important to take warfarin at the same time every day. Warfarin can be taken with or without food.
• It is important to take warfarin regularly to get the most benefit.
• Never take a double dose of this medication.
• Do not stop taking warfarin without first talking to your doctor.
• It will be necessary to regularly monitor your therapy with a blood test called a "PT" or an "INR." These tests help to determine the amount of warfarin that you need to take. Your doctor may also want you to have other blood tests or medical evaluations during treatment with warfarin to monitor progress and side effects.
• Do not take any more or less of this drug than is prescribed for you.
• Avoid sudden changes in your diet. Vitamin K decreases the effects of warfarin. Large amounts of vitamin K are found in foods such as liver, broccoli, brussels sprouts, and green leafy vegetables (e.g., spinach, Swiss chard, coriander, collards, cabbage). Do not change the amount of these foods in your diet without first talking to your doctor.
• Contact your doctor if you experience any unusual bruises or heavily bleeding wounds, diarrhea, infection, or fever during treatment with warfarin.
• Store this medication at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed dose as soon as you remember, on the same day. If the missed dose is not remembered until the next day, skip that dose and take only the next regularly scheduled dose. Never take a double dose of this medication.

What happens if I overdose?

• Seek emergency medical treatment.
• Symptoms of a warfarin overdose include bruising; small, broken blood vessels under the skin; excessive bleeding from cuts or wounds; bleeding from the gums; blood in the stools, urine, or vomit; and excessive menstrual bleeding in women.

What should I avoid while taking warfarin?

• Avoid sudden changes in your diet. Vitamin K decreases the effects of warfarin. Large amounts of vitamin K are found in foods such as liver, broccoli, brussels sprouts, and green leafy vegetables (e.g., spinach, Swiss chard, coriander, collards, cabbage). Do not change the amount of these foods in your diet without first talking to your doctor.
• Do not take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil, Nuprin, others), ketoprofen (Orudis, Orudis KT, Oruvail), naproxen (Naprosyn, Aleve, Anaprox) and others while taking warfarin, except under the direction of your doctor. These medicines increase the risk of bleeding.
• Tell your doctor (or dentist) that you are taking warfarin before taking an antibiotic or before having surgery.
• Do not start or stop taking any other medications during treatment with warfarin without first talking to your doctor.
• Avoid hazardous activities and sports that may cause injuries. Bleeding and bruising may be a problem, especially at the start of therapy. Watch for excessive bleeding and bruising and report any unusual bruises or heavily bleeding wounds to your doctor.
• Avoid the use of alcohol and tobacco products. These products can alter the effects of warfarin and cause problems with your therapy. Discuss the use of alcohol and tobacco with your doctor.