Coumadin

Coumadin

     * Generic Name: warfarin sodium
     * Brand Name: Coumadin


     * What is warfarin (Coumadin, Jantoven)?
     * What are the possible side effects of warfarin (Coumadin,
       Jantoven)?
     * What is the most important information I should know about
       warfarin (Coumadin, Jantoven)?
     * What should I discuss with my healthcare provider before taking
       warfarin (Coumadin, Jantoven)?
     * How should I take warfarin (Coumadin, Jantoven)?
     * What happens if I miss a dose (Coumadin, Jantoven)?
     * What happens if I overdose (Coumadin, Jantoven)?
     * What should I avoid while taking warfarin (Coumadin, Jantoven)?
     * What other drugs will affect warfarin (Coumadin, Jantoven)?
     * Where can I get more information (Coumadin, Jantoven)?

What is warfarin (Coumadin, Jantoven)?

   Warfarin is an anticoagulant (blood thinner). Warfarin reduces the
   formation of blood clots.

   Warfarin is used to treat or prevent blood clots in veins or arteries,
   which can reduce the risk of stroke, heart attack, or other
   serious conditions.

   Warfarin may also be used for purposes not listed in this medication
   guide.

What are the possible side effects of warfarin (Coumadin, Jantoven)?

   Get emergency medical help if you have signs of an allergic reaction:
   hives; difficult breathing; swelling of your face, lips, tongue, or
   throat.

   Warfarin increases your risk of bleeding, which can be severe or
   life-threatening. Call your doctor at once if you have any signs of
   bleeding such as:
     * sudden headache, feeling very weak or dizzy;
     * swelling, pain, unusual bruising;
     * bleeding gums, nosebleeds;
     * bleeding from wounds or needle injections that will not stop;
     * heavy menstrual periods or abnormal vaginal bleeding;
     * blood in your urine, bloody or tarry stools; or
     * coughing up blood or vomit that looks like coffee
       grounds.

   Clots formed by warfarin may block normal blood flow, which could lead
   to tissue death or amputation of the affected body part. Get
   medical help at once if you have:
     * pain, swelling, hot or cold feeling, skin changes, or discoloration
       anywhere on your body; or
     * sudden and severe leg or foot pain, foot ulcer, purple toes or
       fingers.

   Bleeding is the most common side effect of warfarin.

   This is not a complete list of side effects and others may occur. Call
   your doctor for medical advice about side effects. You may report side
   effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about warfarin
(Coumadin, Jantoven)?

   You should not take warfarin if you are prone to bleeding because
   of a medical condition, if you have an upcoming surgery, or if you need
   a spinal tap or epidural. Do not take warfarin if you cannot
   take it on time every day.

   Warfarin increases your risk of severe or fatal bleeding, especially if
   you have certain medical conditions, if you are 65 or older, or if you
   have had a stroke, or bleeding in your stomach or intestines. Seek
   emergency help if you have any bleeding that will not stop.

   Call your doctor at once if you have other signs of bleeding such as:
   swelling, pain, feeling very weak or dizzy, unusual bruising, bleeding
   gums, nosebleeds, heavy menstrual periods or abnormal vaginal bleeding,
   blood in your urine, bloody or tarry stools, coughing up blood or vomit
   that looks like coffee grounds.

   Many other drugs can increase your risk of bleeding when used with
   warfarin. Tell your doctor about all medicines you have recently used.

   Avoid making any changes in your diet without first talking to your
   doctor. Some foods can make warfarin less effective.

   Coumadin Patient Information including How Should I Take
   Heart Disease:The No. 1 Killer in the U.S.

   Heart Disease Slideshow Pictures
   RxList

   Medical Illustrations of the Heart Image Collection
   RxList

   Take the Heart Disease Quiz!

What should I discuss with my healthcare provider before taking warfarin
(Coumadin, Jantoven)?

   You should not take warfarin if you are allergic to it, or if:
     * you have very high blood pressure;
     * you recently had or will have surgery on your brain, spine, or eye;
     * you undergo a spinal tap or spinal anesthesia (epidural); or
     * you cannot take warfarin on time every day.

   You also should not take warfarin if you are are prone to bleeding
   because of a medical condition, such as:
     * a blood cell disorder (such as low red blood cells or low
       platelets);
     * ulcers or bleeding in your stomach, intestines, lungs, or
       urinary tract;
     * an aneurysm or bleeding in the brain; or
     * an infection of the lining of your heart.

   Do not take warfarin if you are pregnant, unless your doctor tells you
   to. Warfarin can cause birth defects, but preventing blood clots
   may outweigh any risks to the baby. If you are not pregnant, use
   effective birth control to prevent pregnancy while taking warfarin and
   for at least 1 month after your last dose. Tell your doctor right away
   if you become pregnant.

   Warfarin can make you bleed more easily, especially if you have ever
   had:
     * high blood pressure or serious heart disease;
     * kidney disease;
     * cancer or low blood cell counts;
     * an accident or surgery;
     * bleeding in your stomach or intestines;
     * a stroke; or
     * if you are 65 or older.

   To make sure warfarin is safe for you, tell your doctor if you have
   ever had:
     * diabetes;
     * congestive heart failure;
     * liver disease, kidney disease (or if you are on dialysis);
     * a hereditary clotting deficiency; or
     * low blood platelets after receiving heparin.

   It is not known whether warfarin passes into breast milk. Watch for
   signs of bruising or bleeding in the baby if you take warfarin while
   you are breast-feeding a baby.

How should I take warfarin (Coumadin, Jantoven)?

   Follow all directions on your prescription label. Your doctor may
   occasionally change your dose. Do not take warfarin in larger or
   smaller amounts or for longer than your doctor tells you to.

   Take warfarin at the same time every day, with or without food. Never
   take a double dose.

   Warfarin can make it easier for you to bleed. Seek emergency help if
   you have any bleeding that will not stop.

   You will need frequent "INR" or prothrombin time tests (to measure your
   blood-clotting time and determine your warfarin dose). You must remain
   under the care of a doctor while taking warfarin.

   If you receive warfarin in a hospital, call or visit your doctor 3 to 7
   days after you leave the hospital. Your INR will need to be tested at
   that time. Do not miss any follow-up appointments.

   Tell your doctor if you are sick with diarrhea, fever, chills, or flu
   symptoms, or if your body weight changes.

   You may need to stop taking warfarin 5 to 7 days before having any
   surgery, dental work, or a medical procedure. Call your doctor for
   instructions.

   Wear a medical alert tag or carry an ID card stating that you take
   warfarin. Any medical care provider who treats you should know that you
   are taking this medicine.

   Store at room temperature away from heat, moisture, and light.

   Coumadin Patient Information including If I Miss a Dose
   Heart Disease:The No. 1 Killer in the U.S.

   Heart Disease Slideshow Pictures
   RxList

   Medical Illustrations of the Heart Image Collection
   RxList

   Take the Heart Disease Quiz!

What happens if I miss a dose (Coumadin, Jantoven)?

   Take the missed dose as soon as you remember. Skip the missed dose if
   it is almost time for your next scheduled dose. Do not take extra
   medicine to make up the missed dose.

What happens if I overdose (Coumadin, Jantoven)?

   Seek emergency medical attention or call the Poison Help line at
   1-800-222-1222. An overdose can cause excessive bleeding.

What should I avoid while taking warfarin (Coumadin, Jantoven)?

   Avoid activities that may increase your risk of bleeding or injury. Use
   extra care to prevent bleeding while shaving or brushing your teeth.
   You may still bleed more easily for several days after you stop taking
   warfarin.

   Avoid making any changes in your diet without first talking to your
   doctor. Foods that are high in vitamin K (liver, leafy green
   vegetables, or vegetable oils) can make warfarin less effective. If
   these foods are part of your diet, eat a consistent amount on a
   weekly basis.

   Grapefruit juice, cranberry juice, noni juice, and
   pomegranate juice may interact with warfarin and lead to unwanted
   side effects. Avoid the use of these juice products while taking
   warfarin.

   Avoid drinking alcohol.

   Ask your doctor before using any medicine for pain, arthritis,
   fever, or swelling. This includes aspirin, ibuprofen (Advil,
   Motrin), naproxen (Aleve), celecoxib (Celebrex),
   diclofenac, indomethacin, meloxicam, and others. These
   medicines may affect blood clotting and may also increase your risk of
   stomach bleeding.

What other drugs will affect warfarin (Coumadin, Jantoven)?

   Many drugs (including some over-the-counter medicines and herbal
   products) can affect your INR and may increase the risk of bleeding if
   you take them with warfarin. Not all possible drug interactions are
   listed in this medication guide. It is very important to ask your
   doctor and pharmacist before you start or stop using any other
   medicine, especially:
     * other medicines to prevent blood clots;
     * an antibiotic or antifungal medicine;
     * supplements that contain vitamin K; or
     * herbal (botanical) products--coenzyme Q10, cranberry,
       echinacea, garlic, ginkgo biloba, ginseng,
       goldenseal, or St. John's wort.

   This list is not complete and many other drugs can interact with
   warfarin. This includes prescription and over-the-counter medicines,
   vitamins, and herbal products. Give a list of all your medicines to any
   healthcare provider who treats you.

Where can I get more information (Coumadin, Jantoven)?

   Your pharmacist can provide more information about warfarin.
     __________________________________________________________________

   Remember, keep this and all other medicines out of the reach of
   children, never share your medicines with others, and use this
   medication only for the indication prescribed.
   Every effort has been made to ensure that the information provided by
   Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete,
   but no guarantee is made to that effect. Drug information contained
   herein may be time sensitive. Multum information has been compiled for
   use by healthcare practitioners and consumers in the United States and
   therefore Multum does not warrant that uses outside of the United
   States are appropriate, unless specifically indicated otherwise.
   Multum's drug information does not endorse drugs, diagnose patients or
   recommend therapy. Multum's drug information is an informational
   resource designed to assist licensed healthcare practitioners in caring
   for their patients and/or to serve consumers viewing this service as a
   supplement to, and not a substitute for, the expertise, skill,
   knowledge and judgment of healthcare practitioners. The absence of a
   warning for a given drug or drug combination in no way should be
   construed to indicate that the drug or drug combination is safe,
   effective or appropriate for any given patient. Multum does not assume
   any responsibility for any aspect of healthcare administered with the
   aid of information Multum provides. The information contained herein is
   not intended to cover all possible uses, directions, precautions,
   warnings, drug interactions, allergic reactions, or adverse effects. If
   you have questions about the drugs you are taking, check with your
   doctor, nurse or pharmacist.