Brand name:
Warf
Pronounced: COO-muh-din
Generic name: Warfarin sodium
Why is Warf prescribed?
Warf is an anticoagulant (blood thinner). It is prescribed to:
* Prevent and/or treat a blood clot that has formed within a blood
vessel or in the lungs.
* Prevent and/or treat blood clots associated with certain heart conditions
or replacement of a heart valve.
* Aid in the prevention of blood clots that may form in blood vessels anywhere
in the body after a heart attack.
* Reduce the risk of death, another heart attack, or stroke after a heart attack.
Most important fact about Warf
The most serious risks associated with Warf treatment are hemorrhage
(severe bleeding resulting in the loss of a large amount of blood)
in any tissue or organ and, less frequently, the destruction of skin
tissue cells (necrosis) or gangrene. The risk of hemorrhage usually
depends on the dosage and length of treatment with Warf.
Hemorrhage and necrosis have been reported to result in death or permanent
disability. Severe necrosis can lead to the removal of damaged tissue
or amputation of a limb. Necrosis appears to be associated with blood
clots located in the area of tissue damage and usually occurs within
a few days of starting Warf treatment.
How should you take Warf?
The objective of treatment with a blood-thinner is to control the
blood-clotting process without causing severe bleeding, so that a clot
does not form and cut off the blood supply necessary for normal body
function. Therefore, it is very important that you take this medication
exactly as prescribed by your doctor and that your doctor monitor your
condition on a regular basis. Be especially careful to stick to the
exact dosage schedule your doctor prescribes.
Effective treatment with minimal complications depends on your cooperation
and communication with the doctor.
Do not take or discontinue any other medication unless directed to
do so by your doctor. Avoid alcohol, salicylates such as aspirin, larger
than usual amounts of foods rich in vitamin K (including liver, vegetable
oil, egg yolks, and green leafy vegetables), which can counteract the
effect of Warf, or any other drastic change in diet.
Note that Warf often turns urine reddish-orange.
You should carry an identification card that indicates you are taking
Warf.
If you miss a dose...
Take the forgotten dose as soon as you remember, then go back to your
regular schedule. If you do not remember until the next day, skip the
dose. Never try to "catch up" by doubling the dose. Keep
a record for your doctor of any doses you miss.
Storage instructions...
Warf can be stored at room temperature. Close the container tightly
and protect from light.
Warf side effects
Side effects cannot be anticipated. If any develop or change in intensity,
inform your doctor as soon as possible. Only your doctor can determine
if it is safe for you to continue taking Warf.
* Side effects may include:
Hemorrhage: Signs of severe bleeding resulting in the loss of large amounts
of blood depend upon the location and extent of bleeding. Symptoms include:
chest, abdomen, joint, muscle, or other pain; difficult breathing or swallowing;
dizziness; headache; low blood pressure; numbness and tingling; paralysis;
shortness of breath; unexplained shock; unexplained swelling; weakness
Why should Warf not be prescribed?
This drug should not be used for any condition where the danger of
hemorrhage may be greater than the potential benefits of treatment.
Unless directed to do so by your doctor, do not take this medication
if one of the following conditions or situations applies to you:
A tendency to hemorrhage
Alcoholism
An abnormal blood condition
Aneurysm (balloon-like swelling of a blood vessel) in the brain or
heart
Bleeding tendencies associated with: ulceration or bleeding of the
stomach, intestines, respiratory tract, or the genital or urinary system
Eclampsia (a rare and serious pregnancy disorder producing life-threatening
convulsions), or preeclampsia (a toxic condition--including headache,
high blood pressure, and swelling of the legs and feet--that can lead
to eclampsia)
Excessive bleeding of brain blood vessels
Inflammation, due to bacterial infection, of the membrane that lines
the inside of the heart
Inflammation of the sac that surrounds the heart or an escape of fluid
from the heart sac
Malignant hypertension (extremely elevated blood pressure that damages
the inner linings of blood vessels, the heart, spleen, kidneys, and
brain)
Pregnancy
Recent or contemplated surgery of the central nervous system (brain
and spinal cord) or eye
Spinal puncture or any procedure that can cause uncontrollable bleeding
Threatened miscarriage
Allergy to any of the drug's ingredients
Special warnings about Warf
Treatment with blood thinners may increase the risk that fatty plaque
will break away from the wall of an artery and lodge at another point,
causing the blockage of a blood vessel. If you notice any of the following
symptoms, contact your doctor immediately:
Abdominal pain; abrupt and intense pain in the leg, foot, or toes;
blood in the urine; bluish mottling of the skin of the legs and hands;
foot ulcers; gangrene; high blood pressure; muscle pain; "purple
toes syndrome" (see below); rash; or thigh or back pain.
If you have any of the following conditions, tell your doctor. He
or she will have to consider the risks against the benefits before
giving you Warf.
An infectious disease or intestinal disorder
A history of recurrent blood clot disorders in you or your family
An implanted catheter
Dental procedures
Inflammation of a blood vessel
Moderate to severe high blood pressure
Moderate to severe kidney or liver dysfunction
Polycythemia vera (blood disorder)
Severe diabetes
Surgery or injury that leaves large raw surfaces
Trauma or injury that may result in internal bleeding
Purple toes syndrome can occur when taking Warf, usually 3 to
10 weeks after the start of anticoagulation therapy. Symptoms include
dark purplish or mottled color of the toes that turns white when pressure
is applied and fades when you elevate your legs, pain and tenderness
of the toes, and change in intensity of the color over a period of
time. If any of these symptoms develop, notify your doctor immediately.
If you are taking Warf, your doctor should periodically check
the time it takes for your blood to start the clotting process (prothrombin
time). Numerous factors such as travel and changes in diet, environment,
physical state, and medication may alter your response to treatment
with an anticoagulant. Clotting time should also be monitored after
your release from the hospital and whenever other medications are started,
discontinued, or taken sporadically.
While taking Warf, avoid activities and sports that could cause
an injury. Remain cautious after you stop taking Warf. It will
continue to work for 2 to 5 days.
If you have congestive heart failure, you may become more sensitive
to Warf and may need to have your dosage reduced. Your doctor will
have you tested regularly.
Notify your doctor if any illness, such as diarrhea, infection, or
fever develops; if any unusual symptoms, such as pain, swelling, or
discomfort, appear; or if you see prolonged bleeding from cuts, increased
menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from
brushing, unusual bleeding or bruising, red or dark brown urine, red
or tarry black stool, headache, dizziness, or weakness.
Possible food and drug interactions when taking Warf
Warf can interact with a very wide variety of drugs, both prescription
and over-the-counter. Check with your doctor before taking ANY other
medication or vitamin product.
Be extremely cautious, too, about taking any herbal remedies and supplements.
A wide assortment of herbal products--including St. John's Wort, coenzyme
Q10, bromelains, dan-shen, dong quai, garlic, and ginkgo biloba--are
known to interact with Warf or otherwise affect coagulation.
Special information if you are pregnant or breastfeeding
Warf should not be taken by women who are or may become pregnant
since the drug may cause fatal hemorrhage in the developing baby. There
have also been reports of birth malformations, low birth weight, and
retarded growth in children born to mothers treated with Warf during
pregnancy. Spontaneous abortions and stillbirths are also known to
occur. If you become pregnant while taking Warf, inform your doctor
immediately.
Warf has not been found in the breast milk of mothers taking the
drug. Nevertheless, the doctor may test the baby for coagulation abnormalities
before recommending that you breastfeed while on Warf therapy.
Recommended dosage for Warf
ADULTS
Overdosage
Signs and symptoms of Warf overdose reflect abnormal bleeding.
* Symptoms of abnormal bleeding include:
Blood in stools or urine, excessive menstrual bleeding, black stools, reddish
or purplish spots on skin, excessive bruising, persistent bleeding from superficial
injuries
