Warfarin (under the brand names Coumadin and Janetown) is a blood thinner and a group of coumarins and indentations that are used to treat or prevent blood clots in the arteries. Warfarin reduces the risk of stroke, heart attack or other serious illnesses and may be prescribed for other purposes. In the following, you will learn more about how to use, side effects and important points related to this anti-clotting drug.
When is warfarin prescribed?
Your doctor may prescribe warfarin for you in the following cases:
- Blood clots in the lungs (pulmonary embolism);
- Blood clots anywhere in the body (vascular thrombosis);
- Use of an artificial heart valve that increases the risk of blood clots;
- A blood clot in or near the heart that can cause a stroke, heart attack, or limb injury;
- Increased risk of blood clots in the heart, which can lead to heart problems (arrhythmia).
Important points before taking warfarin
Avoid activities that increase your chances of bleeding and injury. When shaving your body or brushing your teeth, be extra careful not to bleed. Bleeding may occur easily even a few days after stopping the drug.
Warfarin increases the risk of severe or fatal bleeding. In the following situations, this issue is more acute:
- special disease;
- Age over 65;
- History of stroke;
- History of gastrointestinal bleeding.
Consult your doctor before taking warfarin in the following cases:
- Congestive heart failure;
- Hereditary blood clotting defects;
- Low blood platelets after receiving heparin;
- Liver disease, kidney disease (dialysis).
You should not use warfarin in the following cases:
- High blood pressure;
- Allergy to warfarin;
- Spinal cord injury or spinal anesthesia;
- History of brain, spinal cord and eye surgery or decision to have these surgeries in the near future;
- There is a problem with taking warfarin early.
You should not take warfarin if you are prone to bleeding for medical reasons. These reasons include the following:
- Disorders of blood cells (red blood cells or low platelets);
- Ulceration or bleeding of the stomach, intestines, lungs or urethra;
- Aneurysm or bleeding in the brain;
- Cardiac hemorrhage.
How to take warfarin
- Use the medicine as prescribed by your doctor and follow the instructions on the medicine. Sometimes your doctor may change the dose of the medicine. Do not take warfarin more or less or for longer than prescribed by your doctor.
- Take medicine with or without food at the same time each day. Never use a double dose of medicine.
- You will need regular INRs or prothrombin time tests (PTs) to check your blood clotting time and dose of warfarin. You should be under the supervision of a doctor while using this medicine.
- If you are taking warfarin in the hospital, see your doctor 3 to 7 days after discharge. Your IRN should be checked at that time. Do not forget to see your doctor next time.
The risk of bleeding in some people may be due to genetic reasons; For this reason, your doctor may order a genetic test to determine your dose.
Forget the dose
As soon as you are reminded, take the missed dose. If you are close to taking the next dose, skip the missed dose. Avoid taking twice as much medicine to make up for a forgotten dose.
In case of overdose with warfarin tablets, call the emergency number (115).
Complications of warfarin
The main side effect of warfarin is bleeding. Although the risk of major bleeding is low, you should be aware of potential problems. For example, you may cut your finger or have nosebleeds and the bleeding will not stop. More serious bleeding may occur inside the body.
If you have symptoms of warfarin allergy, including hives, difficulty breathing, swelling of the face, lips, tongue, or throat, see an emergency room right away.
See a doctor right away if you have symptoms of bleeding. Some of these symptoms include:
- Bleeding from wounds or needle injection site that does not stop;
- Heavy menstrual periods or abnormal vaginal bleeding;
- Sudden headache, feeling weak or dizzy;
- Cough or vomiting of blood-like substances;
- Blood in urine, bloody or dark stools;
- Head injury even without bleeding;
- Swelling, pain, unusual bruising;
- Bleeding gums, nosebleeds;
- Severe stomach pain.
Warfarin-induced clots may block normal blood flow, causing tissue death or amputation in one part of the body. Seek emergency help immediately in the following cases:
- Pain, swelling, feeling hot or cold, skin changes, discharge from anywhere on the body;
- Sudden and severe pain in the legs and arms, foot ulcers, bruising of the toes.
These are not a complete list of side effects of warfarin; Other things may happen. Talk to your doctor about the side effects of warfarin. In rare cases, warfarin causes skin tissue death (necrosis). This problem occurs a few days after starting treatment with this drug.
See your doctor in the following cases:
- Any kind of wound;
- Severe pain on the skin;
- Change in skin color or temperature.
Talk to your doctor about the following side effects:
- Diarrhea, vomiting or inability to eat for more than 24 hours.
According to research, the risk of bleeding is higher in the first 3 months of treatment with this drug.
Drug interaction with warfarin
Many medications, including over-the-counter medications and herbal products, can affect your IR. If you take them with warfarin, they increase the risk of bleeding. Consult your doctor or pharmacist before starting or stopping any medication, including:
- Laxatives and antacids;
- Vitamin K supplements;
- Medicines for heart disorders;
- Acetaminophen and products containing it;
- Antibiotics or antifungal drugs;
- Other medicines to prevent blood clots;
- Plant products such as coenzyme Q10 (blue Q10), blueberries, echinacea, garlic, ginkgo, biloba, ginseng, rose hips, calendula, green tea, vitamin E or black licorice;
- Grapefruit juice, blueberry juice and pomegranate juice may interact with this medicine and cause unwanted side effects. Avoid drinking the juice of these fruits while using warfarin.
Consult your doctor before taking any medication for pain, arthritis, fever or swelling. These medications include the following:
These drugs may affect blood clotting and increase gastric bleeding.
Give your doctor a list of your medications. Also avoid alcohol.
The effect of vitamin K on warfarin
Vitamin K is a nutrient for heart and bone health. Foods rich in vitamin K include green vegetables such as lettuce, spinach and broccoli. If you are taking warfarin, the amount of vitamin K in your diet may affect the way the medicine works. That’s why you need to get a steady amount of vitamin K in your diet. Low levels of vitamin K can increase the risk of bleeding, and high levels of it reduce the anticoagulant ability of warfarin.
Talk to your doctor about healthy choices that can give you a steady amount of vitamin K, and do not make any changes to your diet without consulting your doctor.
Taking warfarin under certain conditions
Warfarin during pregnancy
Do not take warfarin tablets during pregnancy without a doctor’s prescription. Warfarin can cause birth defects, but preventing blood clots is preferable to any risk. If you are not pregnant, take birth control pills during the period of taking the medicine and one month after the last dose. If you become pregnant, consult your doctor.
Warfarin during lactation
It is not known whether warfarin passes into breast milk. If you are taking this medicine while breastfeeding, look for signs of bruising or bleeding in your baby.
What can we do to reduce the risk of bleeding with warfarin?
- Tell your friends and family that you are taking warfarin. In an emergency, they know what medicine you have been taking.
- Talk to your doctor about all medications, herbal products, and vitamins you take, and get tested to see if they work.
- Use safe cosmetics. Using a soft toothbrush, floss, and electric razor can prevent bleeding.
- Be careful not to get injured. Avoid activities and sports that increase the risk of head injuries. Use protective gear when cycling. Tell your doctor if you lose your balance while walking or have a history of fainting.
- Tell your doctor about taking warfarin before having any surgery or dental work. You may need to reduce or stop taking warfarin at least 5 days before surgery. During this time, your doctor may prescribe another diluent, such as heparin.
New alternative drugs have entered the market, some of which are oral pills and some are subcutaneous injections. The names of some of the drugs are summarized here:
- Dabigatran tablets;
- Apixaban tablets;
- Adoxaban tablets;
- Rivaroxaban tablets;
- Daltparin injection drug;
- Enoxaparin injection drug;
- Fondaparinux injection drug.
- Do not share medicine with others.
- Keep the medicine out of the reach of children and animals.
- Talk to your doctor about the information in this article.
- Use warfarin only as prescribed.
- Keep the medicine at room temperature away from heat, humidity and heat.
- Tell your doctor if you have diarrhea, fever, chills, flu symptoms or weight changes.
- Tell those around you and other doctors you are in contact with that you are taking warfarin tablets.
- Do not change your diet without consulting your doctor. Some medications can reduce the effectiveness of this medication.
- Warfarin facilitates bleeding. If your bleeding does not stop, go to the emergency room right away.
- Taking certain medications with warfarin may increase the risk of bleeding. Talk to your doctor about any medications you have just started taking.
How useful was the content of this article for you? Do you have any experience with warfarin? If you wish, you can write your opinion in the “Send Comment” section to us and share this article with your loved ones through social networks.