Warfarin

Warfarin is used to prevent blood clots from forming or growing larger in your blood and blood vessels. It is prescribed for people with certain types of irregular heartbeat, people with prosthetic (replacement or mechanical) heart valves, and people who have suffered a heart attack. Warfarin is also used to treat or prevent venous thrombosis (swelling and blood clot in a vein) and pulmonary embolism (a blood clot in the lung). Warfarin is in a class of medications called anticoagulants ('blood thinners'). It works by decreasing the clotting ability of the blood.

Warfarin comes as a tablet to take by mouth. It is usually taken once a day with or without food. Take warfarin at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take warfarin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Call your doctor immediately if you take more than your prescribed dose of warfarin. Your doctor will probably start you on a low dose of warfarin and gradually increase or decrease your dose based on the results of your blood tests. Make sure you understand any new dosing instructions from your doctor. Continue to take warfarin even if you feel well. Do not stop taking warfarin without talking to your doctor.

<p></p> <p></p> <p></p> <p>Warfarin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

<ul>
<li>
gas</li>
<li>
change in the way things taste</li>
<li>
tiredness</li>
<li>
pale skin</li>
<li>
loss of hair</li>
<li>
feeling cold or having chills</li></ul></p> <p></p> <p>If you experience any of the following symptoms, or those listed in the IMPORTANT WARNING section, call your doctor immediately:

<ul>
<li>
hives</li>
<li>
rash</li>
<li>
itching</li>
<li>
difficulty breathing or swallowing</li>
<li>
swelling of the face, throat, tongue, lips, or eyes</li>
<li>
hoarseness</li>
<li>
chest pain or pressure</li>
<li>
swelling of the hands, feet, ankles, or lower legs</li>
<li>
fever</li>
<li>
infection</li>
<li>
nausea </li>
<li>
vomiting</li>
<li>
diarrhea</li>
<li>
loss of appetite</li>
<li>
pain in the upper right part of the stomach</li>
<li>
yellowing of the skin or eyes</li>
<li>
flu-like symptoms</li>
<li>
joint or muscle pain</li>
<li>
difficultly in moving any part of your body</li>
<li>
feelings of numbness, tingling, pricking, burning, or creeping on the skin</li>
<li>
painful erection of the penis that lasts for hours</li></ul>You should know that warfarin may cause necrosis or gangrene (death of skin or other body tissues). Call your doctor immediately if you notice a purplish or darkened color to your skin, skin changes, ulcers, or an unusual problem in any area of your skin or body, or if you have a severe pain that occurs suddenly, or color or temperature change in any area of your body. Call your doctor immediately if your toes become painful or become purple or dark in color. You may need medical care right away to prevent amputation (removal) of your affected body part.Warfarin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.</p>

Before taking warfarin, tell your doctor and pharmacist if you are allergic to warfarin or any other medications. do not take two or more medications that contain warfarin at the same time. Be sure to check with your doctor or pharmacist if you are uncertain if a medication contains warfarin or warfarin sodium. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take, especially antibiotics; aspirin or aspirin-containing products and other nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); heparin; medications for cancer, cholesterol, colds and allergies, depression, diabetes, digestive problems (including ulcers and heartburn), gout, heart disease, mental illness, pain,seizures, thyroid problems, and tuberculosis; oral contraceptives (birth control pills); streptokinase; ticlopidine; or urokinase. Many other medications may also interact with warfarin, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. Do not take any new medications or stop taking any medication without talking to your doctor. tell your doctor and pharmacist what herbal or botanical products you are taking, especially bromelains, coenzyme Q10 (Ubidecarenone), cranberry products, danshen, dong quai, garlic, Ginkgo biloba, ginseng, and St. John's wort. There are many other herbal or botanical products which might affect your body's response to warfarin. Do not start or stop taking any herbal products without talking to your doctor. tell your doctor if you have or have ever had a thyroid condition or diabetes. Also tell your doctor if you have an infection, a gastrointestinal illness such as diarrhea, or sprue (an allergic reaction to protein found in grains that causes diarrhea), or an indwelling catheter (a flexible plastic tube that is placed into the bladder to allow the urine to drain out). if you are having surgery, including dental surgery, or any type of medical or dental procedure, tell the doctor or dentist that you are taking warfarin. Your doctor may tell you to stop taking warfarin before the surgery or procedure or change your dosage of warfarin before the surgery or procedure. Follow your doctor's directions carefully and keep all appointments with the laboratory if your doctor orders blood tests to find the best dose of warfarin for you. tell your doctor if you drink or have ever drunk large amounts of alcohol. Your doctor will probably tell you not to take warfarin. Avoid drinking alcohol while you are taking this medication. If you are going to receive an immunization, such as a flu shot, or any other injection into a muscle, tell the health care professional that you are taking warfarin.

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911. Symptoms of overdose may include:

<ul>
<li>
bloody or red, or tarry bowel movements</li>
<li>
spitting or coughing up blood</li>
<li>
heavy bleeding with your menstrual period</li>
<li>
pink, red, or dark brown urine</li>
<li>
coughing up or vomiting material that looks like coffee grounds</li>
<li>
small, flat, round red spots under the skin </li>
<li>
unusual bruising or bleeding</li>
<li>
continued oozing or bleeding from minor cuts</li></ul>