warfarin: What is, what is used for, dose, side effects, brands

WARFARIN

Indications and usage
Important information
Before taking
How to use
While taking
Side effects
Brands

List of brands containing warfarin

This page contains list of brands of authorized pharmaceutical specialties of the active principle warfarin in the countries listed below:

[ Australia] [ Brazil] [ Canada] [ France] [ Germany] [ India] [ Italy] [ Japan] [ Korea] [ Mexico] [ Puerto Rico] [ Spain] [ Turkey] [ United Kingdom] [ U.S.A]

Given the nature of the pharmaceutical market, some specialties may be unavailable, have been removed from pharmaceutical market or have changed its name. So that, in no case can take decisions based on the information contained in the page. MEDIZZINE is not responsible for any damage arising from the information provided, which may be incomplete or outdated.

Indications and usage ▲

Warfarin is an oral anticoagulant that acts by inhibiting the hepatic synthesis of the active forms of coagulation factors (II, VII, IX, X) competing with Vitamin K. Administered orally, warfarin induces a hypoprothrombinemia 36-72 hours after. The anticoagulant action may persist 4-5 days after completion of treatment.

Warfarin is used for:

- Prophylaxis and/or treatment of venous thrombosis and its extension, and pulmonary embolism.
- Prophylaxis and/or treatment of thromboembolic complications associated with atrial fibrillation and/or cardiac valve replacement.

It is also indicated in reducing the risk of death from recurrent myocardial infarction as well as thromboembolic events such as stroke or systemic embolization.

Medizzine recommends consult your doctor if you are unsure (or you do not know) why you have been given warfarin.

Other ingredients of available commercial presentations:

Each tablet contains warfarin (INN) sodium, 1, 3, 5 or 10 mg. The other components include lactose and a different dye for each dosage form.

Warning:

The composition of the various presentations may vary from one country to another. We recommend you consult the information provided by your local supplier.

Important information ▲

The tablets contain lactose. If your doctor has told you have an intolerance to some sugars, contact him before taking it.

Before taking the drug ▲

Do not use warfarin

If you are allergic (hypersensitive) to the active substance warfarin or any of the other ingredients of the medicinal product prescribed to you. If you think you may be allergic, ask your doctor.

Allergy symptoms may include:

- Asthma attacks with shortness of breath, audible wheezing or rapid breathing.
- More or less sudden swelling of face, lips, tongue or elsewhere in the body. It is especially critical if it affects the vocal cords.
- Hives, itching, rash
- Anaphylactic shock (loss of consciousness, paleness, sweating, etc.).

Nor you should take this medicine:

- In case of pregnancy.
- If is lacking the cooperation of patient for appropriate controls (INR) and compliance of treatment.
- In pathological conditions in which the risk of bleeding is greater than the possible clinical benefit, eg bleeding diathesis and/or hematic dyscrasia.
- If you have organic lesions liable to bleed.
- In case of recent or planned surgery on the central nervous system, eye surgery and traumatic interventions that expose large areas of tissue.
- In case of peptic ulcer or apparent bleeding in the gastrointestinal, urogenital or respiratory tracts, cerebrovascular bleeding, pericarditis and pericardial effusions, or slow endocarditis.
- If you have severe high blood pressure or severe liver or kidney injury.
- If you have an increased fibrinolytic activity (for example, after lung or prostate surgery).
- If you receive high doses of anti-inflammatory drugs (NSAIDs), miconazole (systemic route and oral gel), high doses acetylsalicylic acid or other salicylates at high doses.

Take special care with warfarin

In the following conditions must be weighed the risks of anticoagulant therapy against the possible benefits:

- Renal or hepatic failure, from moderate to severe.
- Infectious diseases or alterations of the intestinal flora.
- Trauma which may result in internal bleeding.
- Surgery or trauma from large exposed surfaces.
- Catheters.
- Moderate to severe hypertension.
- Known or suspected deficiency in anticoagulant response mediated by protein C, which can cause tissue necrosis.
- Debilitated or elderly patients.

Periodic determination of prothrombin time (INR) is essential. Numerous factors, alone or in combination, the physical condition of the patient or concurrent medications, can modify the patient's response to anticoagulant.

It is generally a good practice to monitor the patient's response with additional INR determinations in the period immediately after leaving the hospital, and when starting, interrupting or adding other medications as needed.

Strictly observe the following recommendations:

- You need to follow the exact dosing schedule proposed by the doctor.
- Avoid alcohol.
- Do not take this medicine during pregnancy.
- Avoid any activity or sport that may result in traumatic injury.
- Patients should carry an identification stating the use of an anticoagulant.
- Contact your doctor if any illness occurs, such as diarrhea, infection, fever or unusual bleeding.
- If warfarin therapy is interrupted, it should be noted that the anticoagulant effects may persist for 2 to 5 days.

If in doubt, consult your doctor.

Taking other medicines

Tell your doctor or pharmacist if you are taking or have recently taken any medications, even those without a prescription or herbal remedies.

Whenever be started or be interrupted a concurrent warfarin therapy, must be made repeated determinations of INR until obtain a stable value.

If you are taking any other medicines (even those sold without a prescription and herbal medicines) consult your doctor.

Medicines and products that may increase the response to warfarin:

allopurinol, analgesics (dextropropoxyphene, tramadol), antiarrhythmic (amiodarone), antibacterial (ciprofloxacin, clarithromycin, erythromycin, norfloxacin, chloramphenicol), antiulcer (cimetidine, omeprazole, ranitidine), cisapride, disulfiram, statins (fluvastatin, lovastatin, simvastatin), fluconazole, fluorouracil, fluvoxamine, interferon alpha and beta, itraconazole, metronidazole, tamoxifen, inactive influenza viruses, ethacrynic acid, nalidixic acid, nonsteroidal antiinflammatory drugs (NSAIDs) (diclofenac, phenylbutazone, ibuprofen, ketoprofen, mefenamic acid, sulindac), miconazole, carnitine, thyroid hormones, neomycin, paracetamol, quinidine, vitamin E, cephalosporins (cefamandole), clofibrate, stanozolol, piracetam, propranolol, salicylates (acetylsalicylic acid, diflunisal), tetracyclines, ticlopidine.

Medicines and products that can reduce the response to warfarin:

aminoglutethimide, carbamazepine, phenazone, griseofulvin, barbiturates, rifampicin, contraceptives containing estrogen, cholestyramine, corticosteroids, diuretics, mercaptopurine, vitamin K, sucralfate, ginseng, ascorbic acid.

Other drugs and products that can increase or decrease the response to warfarin:

Alcohol, chloral hydrate, disopyramide.

These lists are not exhaustive, so you should consult with the doctor about any medicine prescribed for you, even if not included in this web page.

Remember that your doctor has prescribed this medicine only for you. Never give it to someone else.

Special physiological situations

Always consult your doctor or pharmacist before taking any medicine during pregnancy or lactation.

Pregnancy:

Always check with your doctor or pharmacist before taking any medicine during pregnancy or lactation.

Oral coumarin-derivative anticoagulants such as warfarin, cross the placenta and its use is not recommended during pregnancy.

Have been described congenital malformations and other adverse effects on fetal development in children born to mothers taking this medication during the first quarter.

Oral anticoagulants cross the placenta, involving risk of fetal or placental bleeding when administered weeks before delivery. If anticoagulant therapy is required, the use of heparin is recommended, especially during the first trimester, as it does not cross the placenta.

Patients undergoing anticoagulation therapy should be informed which must consult their doctor as soon as suspect they may be pregnant. To those women who become pregnant while receiving this medication, they should be informed about potential hazards to the fetus.

Lactation:

Virtually no warfarin is detected in breast milk, therefore they are not to be feared unwanted effects in infants.

Childre and adolescents:

There are not sufficient clinical data to support the use of this medicine in children.

Driving and using machines

It have not been described negative influences on the ability to drive or operate machinery.

Consult your doctor or pharmacist before taking any medicine.

How to use warfarin ▲

Follow exactly instructions of use of warfarin provided by your doctor. Consult your doctor or pharmacist when in doubt. Follow the instructions of the physician in preference to those given in this website, which may be different. Ask your doctor to explain any aspect that you do not understand, contained in the instruction leaflet that comes with the medicine.

The dosage and administration of warfarin must be individualized for each patient according to the particular patient's response to medicine. The dosage should be adjusted based on the value of INR which must reach values between 2.0 and 3.5, depending on disease.

Your doctor will tell you the most suitable INR value for you, as well as the minimum and maximum values recommended in your case.

initial dosage:

In general, it is recommended initiating therapy with 2-5 mg of warfarin daily with dose adjustments based on the results of INR's values.

Maintenance dose:

Most patients are satisfactorily maintained with a dose of 2 to 10 mg daily. The individual dose and interval should be adjusted according to patient response.

Duration of treatment:

Duration of therapy for each patient must be individualized. In general, anticoagulant therapy should be continued until the danger of thrombosis and embolism disappear.

If you think the effect of the medicine is too strong or too weak, consult your doctor.

If you have any further questions on the use of this product, ask your doctor or pharmacist.

While you take warfarin ▲

If a doctor prescribes another medicine , tell you are taking warfarin.

Check with your doctor regularly developments of disorder that motivates the use of warfarin. Maybe there is some reason that prevented you properly receive the indicated doses and induce your doctor to erroneous conclusions about treatment.

Do not restart treatment with warfarin at your own risk without first talking to your doctor, nor encourage its use by another person, even if have the same symptoms you have. Nor is it advisable to interrupt or reduce the dose without considering the opinion of your doctor.

If you feel unwell during treatment with warfarin, immediately consult your doctor.

If you take more than you should:

Monitoring of overdose without symptoms need proper dosage reduction and constant control. The steps are as follows, according to whether or not exist bleeding complications:

1. In case of overdose with INR < 6 and in the absence of bleeding: temporarily stop the anticoagulant therapy and restart it again with a lower dose, depending on the INR.

2. In case of overdose with INR > 6 and in the absence of major bleeding: dministered 0.5 mg of vitamin K1 by continuous infusion during 20-30 minutes. Increase the vitamin K dosage to 1 mg if the INR = 10.

3. In case of overdose with severe haemorrhage: administer 10-20 mg Vitamin K1 by injection in slow continuous infusion during 1 hour, together with a transfusion of fresh-frozen plasma or whole blood or a commercial complex of Factor IX.

In case of overdose or accidental ingestion, go immediately to the hospital and carry the pack with the remains unconsumed medication or consult the Toxicology Information Service of your country

If you forget to take warfarin

The anticoagulant effect of warfarin persists over 24 hours. If the patient forgets to take it at the just time, the dose should be taken as soon as possible on the same day.

Do not take a double dose to make up for missed doses. You should consult your doctor about this question.

If you have any further questions on the use of this product, ask your doctor or pharmacist.

Side Effects of warfarin ▲

Like all medicines, warfarin can cause side effects, although not everybody gets them.

The frequency of side effects is classified into:

Very common: affect 1 out of 1-10 patients
Common: affect 1 out of 10-100 patients
Uncommon: affect 1 out of 100-1.000 patients
Rare: affect 1 out of 1.000-10.000 patients
Very Rare: affect less than 1 in 10,000 patients
Incidence not known: Can not be established the true incidence from the available data

The most common side effects are bleeding from any tissue or organ, caused by the anticoagulant effect. Signs and symptoms vary according to the location and degree or extent of bleeding.

In addition, there may be gastric irritation, dermatitis, alopecia, necrosis of skin and other areas, although these side effects are very rare..

This list not includes all adverse reactions associated with the use of warfarin, both well established as those that are under consideration or confirmation. In case you feel unwell, should immediately consult with the doctor who prescribed this medicine.

If you notice any side effects not listed in this website or in the leaflet accompanying the package, ask your doctor or pharmacist.

If any of the side effects gets serious, tell your doctor or pharmacist.

List of brands containing warfarin ▲

This page contains list of brands of authorized pharmaceutical specialties of the active principle warfarin in the countries listed below:

[ Australia] [ Brazil] [ Canada] [ France] [ Germany] [ India] [ Italy] [ Japan] [ Korea] [ Mexico] [ Puerto Rico] [ Spain] [ Turkey] [ United Kingdom] [ U.S.A]

Warning:

With exceptions expressly indicated, these lists do not include active principle associations with other drugs or clinical use containers.

Australia: ▲

COUMADIN 1 mg, tablets
COUMADIN 2 mg, tablets
COUMADIN 5 mg, tablets
MAREVAN 1 mg, tablets
MAREVAN 3 mg, tablets
MAREVAN 5 mg, tablets

Brazil: ▲

COUMADIN 1 mg, tablets
COUMADIN 2.5 mg, tablets
COUMADIN 5 mg, tablets
MAREVAN 2.5 mg, tablets
MAREVAN 5 mg, tablets
MAREVAN 7.5 mg, tablets
MARFARIM 5 mg, tablets
VARFARINA TEUTO 5 mg, tablets
VARFARINA UNIAO QUIMICA 5 mg, tablets

Canada: ▲

APO-WARFARIN 1 mg, tablets
APO-WARFARIN 1 mg, tablets
APO-WARFARIN 2 mg, tablets
APO-WARFARIN 2.5 mg, tablets
APO-WARFARIN 3 mg, tablets
APO-WARFARIN 4 mg, tablets
APO-WARFARIN 5 mg, tablets
APO-WARFARIN 10 mg, tablets
COUMADIN 1 mg, tablets
COUMADIN 2 mg, tablets
COUMADIN 2.5 mg, tablets
COUMADIN 3 mg, tablets
COUMADIN 4 mg, tablets
COUMADIN 5 mg, tablets
COUMADIN 6 mg, tablets
COUMADIN 10 mg, tablets
MYLAN-WARFARIN 1 mg, tablets
MYLAN-WARFARIN 2 mg, tablets
MYLAN-WARFARIN 2.5 mg, tablets
MYLAN-WARFARIN 3 mg, tablets
MYLAN-WARFARIN 4 mg, tablets
MYLAN-WARFARIN 5 mg, tablets
MYLAN-WARFARIN 6 mg, tablets
MYLAN-WARFARIN 7.5 mg, tablets
MYLAN-WARFARIN 10 mg, tablets
NOVO-WARFARIN 1 mg, tablets
NOVO-WARFARIN 2 mg, tablets
NOVO-WARFARIN 2.5 mg, tablets
NOVO-WARFARIN 3 mg, tablets
NOVO-WARFARIN 4 mg, tablets
NOVO-WARFARIN 5 mg, tablets
TARO-WARFARIN 1 mg, tablets
TARO-WARFARIN 1 mg, tablets
TARO-WARFARIN 2 mg, tablets
TARO-WARFARIN 2.5 mg, tablets
TARO-WARFARIN 3 mg, tablets
TARO-WARFARIN 4 mg, tablets
TARO-WARFARIN 5 mg, tablets
TARO-WARFARIN 6 mg, tablets
TARO-WARFARIN 7.5 mg, tablets
TARO-WARFARIN 10 mg, tablets

France: ▲

COUMADINE 2 mg, diivisible tablets
COUMADINE 5 mg, diivisible tablets

Germany: ▲

COUMADIN 5 mg, tablets

India: ▲

SOFARIN 1 mg, tablets
SOFARIN 2 mg, tablets
SOFARIN 5 mg, tablets
UNIWARFIN 5 mg, tablets
WARF 1 mg, tablets
WARF 2 mg, tablets
WARF 3 mg, tablets
WARF 5 mg, tablets

Italy: ▲

COUMADIN 5 mg, tablets

Japan: ▲

WAFARIN 0.5 & 5 mg, tablets
WARFARIN EISAI 0.2%, fine gran
WARFARIN EISAI. 0.5, 1, 2 & 5 mg, tablets
WARFARIN NISSIN PHARMA 1 mg, tablets
WARFARIN NP 0.5, 1 & 2 mg, tablets
WARFARIN NS 0.2%, fine gran
WARFARIN TEVA 0.5 & 1 mg, tablets
WARFARIN TOWA 0.5 & 1 mg, tablets
WARFARIN YD 0.2%, fine gran
WARFARIN F 1 mg, tablets

Korea: ▲

JEIL COUMADIN 1, 2 & 10 mg, tablets
JEIL WARFARIN 5 mg, tablets
KUFARIN 2 & 5 mg, tablets
TARO WARFARIN SODIUM 2.5, 3, 4, 6, 7.5 & 10 mg, tablets
WARFAR 2 & 5 mg, tablets
WARFARIN DAEHWA 1, 2, 3 & 5 mg, tablets

Mexico: ▲

COUMADIN 1 mg, 30 tablets
COUMADIN 2.5 mg, 30 tablets
COUMADIN 5 mg, 30 tablets

Spain: ▲

ALDOCUMAR 1 mg, 40 tablets
ALDOCUMAR 3 mg, 40 tablets
ALDOCUMAR 5 mg, 40 tablets
ALDOCUMAR 10 mg, 40 tablets

Turkey: ▲

COUMADIN 10 mg, tablets
COUMADIN 5 mg, tablets

United Kingdom: ▲

MAREVAN 1 mg, tablets
MAREVAN 0.5 mg, tablets
MAREVAN 3 mg, tablets
MAREVAN 5 mg, tablets
MAREVAN 1 mg, tablets
MAREVAN 1 mg, tablets
MAREVAN 1 mg, tablets
MAREVAN 1 mg, tablets
WARFARIN AAH PHARMA 0.5 mg, tablets
WARFARIN AAH PHARMA 1 mg, tablets
WARFARIN AAH PHARMA 3 mg, tablets
WARFARIN AAH PHARMA 5 mg, tablets
WARFARIN AAH PHARMA 1 mg/ml, oral suspension
WARFARIN ACTAVIS 0.5 mg, tablets
WARFARIN ACTAVIS 1 mg, tablets
WARFARIN ACTAVIS 3 mg, tablets
WARFARIN ACTAVIS 5 mg, tablets
WARFARIN ALLIANCE HEALTHCARE 0.5 mg, tablets
WARFARIN ALLIANCE HEALTHCARE 1 mg, tablets
WARFARIN ALLIANCE HEALTHCARE 3 mg, tablets
WARFARIN ALLIANCE HEALTHCARE 5 mg, tablets
WARFARIN ALLIANCE HEALTHCARE 1 mg/ml, oral suspension
WARFARIN ALMUS 1 mg, tablets
WARFARIN ALMUS 3 mg, tablets
WARFARIN ALMUS 5 mg, tablets
WARFARIN KENT PHARMA 0.5 mg, tablets
WARFARIN KENT PHARMA 1 mg, tablets
WARFARIN KENT PHARMA 3 mg, tablets
WARFARIN KENT PHARMA 5 mg, tablets
WARFARIN MERCURY PHARMA 0.5 mg, tablets
WARFARIN ROSEMONT 1 mg/ml, oral suspension
WARFARIN TEVA 1 mg, tablets
WARFARIN TEVA 3 mg, tablets
WARFARIN TEVA 5 mg, tablets

U.S.A. and Puerto Rico: ▲

COUMADIN 1, 2, 2.5, 3, 4, 5, 6, 7.5 & 10 mg, tablets
COUMADIN 2 mg/ml, IV solution
JANTOVEN 1, 2, 2.5, 3, 4, 5, 6, 7.5 & 10 mg, tablets
WARFARIN AMERICAN HEALTH PACK 2, 2.5 & 5 mg, tablets
WARFARIN BARR 1, 2, 2.5, 3, 4, 5, 6, 7.5 & 10 mg, tablets
WARFARIN BRYANT RANCH PREPACK 1, 2, 2.5, 5 & 7.5 mg, tablets
WARFARIN CADILA HEALTHCARE 1, 2, 2.5, 3, 4, 5, 6, 7.5 & 10 mg, tablets
WARFARIN CAMBER PHARMA 1, 2, 2.5, 3, 4, 5, 6, 7.5 & 10 mg, tablets
WARFARIN CARDINAL HEALTH 1, 2, 2.5, 3, 4, 5 & 6 mg, tablets
WARFARIN GENPHARM 1, 2, 2.5, 3, 4, 5, 6, 7.5 & 10 mg, tablets
WARFARIN GOLDEN STATE MED SUPP 1, 2, 2.5, 3, 4, 5, 6, 7.5 & 10 mg, tablets
WARFARIN MED HEALTH PHARMA 1, 2, 2.5, 3, 4, 5, 6, 7.5 & 10 mg, tablets
WARFARIN MYLAN 1, 2, 2.5, 3, 4, 5, 6, 7.5 & 10 mg, tablets
WARFARIN PD-RX PHARMA 1 & 5 mg, tablets
WARFARIN PHYSICIANS TOTAL CARE 1, 2, 2.5, 3, 4, 5, 6, 7.5 & 10 mg, tablets
WARFARIN REBEL 1, 2, 2.5, 3, 4, 5, 6, 7.5 & 10 mg, tablets
WARFARIN REMEDYREPACK 1, 2, 2.5, 3, 4, 5, 6, 7.5 & 10 mg, tablets
WARFARIN STAT FLORIDA DOH CENTRAL PHARMACY 1, 2, 2.5, 3, 5, 7.5 & 10 mg, tablets
WARFARIN STAT RX USA LLC 1 & 2 mg, tablets
WARFARIN TARO 1, 2, 2.5, 3, 4, 5, 6, 7.5 & 10 mg, tablets
WARFARIN ZYDUS 1, 2, 2.5, 3, 4, 5, 6, 7.5 & 10 mg, tablets

Page updated: December 21, 2010.