Warfarin Sodium

💊 What is Warfarin Sodium used for?

• •Preventing and treating venous thrombosis (blood clots in the veins, such as deep vein thrombosis) and its extension
• •Preventing and treating pulmonary embolism (a clot in the lungs)
• •Preventing and treating clot-related problems linked to atrial fibrillation (an irregular heartbeat) and/or a heart valve replacement
• •Lowering the risk of death, another heart attack, and stroke or other blood clot events after a heart attack
• •The label says warfarin does not dissolve a clot that has already formed. Its goal is to keep the clot from growing and prevent further clot problems.

How it works

The label describes warfarin as an anticoagulant. It works by blocking vitamin K-dependent clotting factors, which are proteins the body needs to form clots. This makes blood clot more slowly.

How it is usually taken

• •The label says to take warfarin exactly as prescribed. The dose is individualized and adjusted based on your INR (a blood test that shows how fast your blood clots). You need regular INR blood tests and visits with your healthcare provider. The label also says to eat a normal, balanced diet and to talk to your provider before making diet changes. Follow the instructions from your prescriber or pharmacist.

Comes as

• •Warfarin sodium tablets USP, 2 mg: lavender, capsule-shaped, scored tablets marked TV/2 on the scored side and 1713 on the other side

⚠️ Warfarin Sodium side effects

🛑 Who should not take Warfarin Sodium, and who should be careful

The label says not to take it if

• 🚨Your risk of bleeding is higher than the possible benefit of treatment. Your healthcare provider decides this.
• 🚨You are pregnant, unless you have a mechanical heart valve. The label says warfarin may cause birth defects, miscarriage, or death of an unborn baby.
• 🚨You are allergic to warfarin or any of its other ingredients
• 🚨You have bleeding tendencies or blood disorders (hemorrhagic tendencies or blood dyscrasias)
• 🚨You have recent or planned surgery of the central nervous system or eye, or traumatic surgery that leaves large open surfaces
• 🚨You have active ulcers or bleeding in the stomach and intestines, urinary tract, or breathing passages, or bleeding in the brain
• 🚨You have cerebral aneurysms, a dissecting aorta, pericarditis or pericardial effusions, bacterial endocarditis, threatened abortion, eclampsia, or preeclampsia
• 🚨The label also lists unsupervised patients with conditions linked to a high level of non-compliance (not following directions)

Tell your doctor before taking it if

• •Tell your provider if you have bleeding problems, fall often, have liver or kidney problems, or are on dialysis
• •Tell your provider about high blood pressure, congestive heart failure, diabetes, or any heart problem
• •Tell your provider if you are pregnant, plan to become pregnant, or are breastfeeding
• •Tell all your providers and dentists that you take warfarin, and tell them before any surgery or dental procedure. The label says the medicine may need to be paused briefly or the dose adjusted.
• •The label lists other factors linked to higher bleeding risk, including age 65 or older, past stomach or intestinal bleeding, high blood pressure, past stroke or mini-stroke, serious heart disease, low blood count or cancer, recent trauma, kidney problems, use of certain other medicines, and long-term use.
• •Your provider will do a pregnancy test before you start treatment, according to the label.

🔀 Warfarin Sodium with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Drugs that increase bleeding risk, including NSAIDs (non-steroidal anti-inflammatory drugs) and medicines containing heparin or other medicines used to prevent or treat blood clots
• •Antibiotics, antifungals, and corticosteroids. The label says INR should be checked more often when these are started, stopped, or changed.
• •Herbal (botanical) products and vitamins or supplements. Tell your provider about everything you take.
• •Medicines that inhibit or induce the liver enzymes CYP2C9, CYP1A2, or CYP3A4. These can raise or lower the effect of warfarin.
• •Other products that contain warfarin. The label says not to take them with warfarin tablets.
• •Ticlopidine: the label says cholestatic hepatitis (a liver problem) has been linked to taking it with warfarin
• •Vitamin K: too much vitamin K from foods such as large amounts of leafy green vegetables or certain vegetable oils can lower the effect of warfarin.
• •Do not change, stop, or start any medicine before talking to your healthcare provider.

Alcohol and food

The label does not mention alcohol. For food, the label says to eat a normal, balanced diet, avoid large amounts of leafy green vegetables and certain vegetable oils because they contain vitamin K, and talk to your provider before making any diet changes.

🤰 Warfarin Sodium in pregnancy and breastfeeding

Pregnancy

The label says warfarin is contraindicated (not to be used) in pregnant women, except pregnant women with mechanical heart valves who are at high risk of blood clots. Warfarin can cause birth defects, miscarriage, fatal fetal bleeding, and fetal death. Females who can become pregnant should use effective birth control during treatment and for at least 1 month after the last dose. Your provider will do a pregnancy test before you start.

Breastfeeding

The label says you and your healthcare provider should decide together whether to take warfarin and breastfeed. If you take warfarin and breastfeed, check your baby for bruising or bleeding.

🗓️ Storage, missed doses and taking too much

Storage

Store at 20 to 25 degrees C (68 to 77 degrees F). Protect from light and keep the container tightly closed. The label says the tablets should be in a tight, light-resistant, child-resistant container.

If a dose is missed

The missed-dose instructions in the label text provided are cut off. Ask your pharmacist or prescriber what to do if you miss a dose.

If too much is taken

The label says that signs of too much anticoagulation (excessive blood thinning) include bleeding, such as blood in stools or urine, heavy menstrual bleeding, excessive bruising, or unexplained drop in hemoglobin. Treatment depends on INR level, whether bleeding is present, and the clinical situation. The label says stopping warfarin and, if needed, giving vitamin K1 can reverse the effect. Seek medical help right away if you think you have taken too much.

🗒️ Questions to ask about Warfarin Sodium

• What INR range is my target, and how often will I need INR blood tests?
• What should I do if I miss a dose?
• Which of my current medicines, supplements, or herbs could affect warfarin?
• How should I change my diet, especially foods with vitamin K?
• Do I need to pause warfarin before any surgery or dental work?
• What signs of bleeding should make me call you right away?

❓ Warfarin Sodium: frequently asked questions