Coumadin (Warfarin)

(℞) Prescription Required

    Coumadin (Warfarin) Dosage and Side Effects

    COUMADIN is an anticoagulant drug. “Anti” means against, and “coagulant” refers to blood clotting. An anticoagulant helps reduce clots from forming in the blood.

    Warnings and Precautions

    Do not use Coumadin if:

    you are pregnant, in particular if you have a high risk pregnancy. Use effective measures to avoid pregnancy while taking COUMADIN. This is very important because your unborn baby could be seriously harmed if you take COUMADIN while you are pregnant. Your baby could be born with birth defects or could die.

    • you have recently had or are planning to have surgery of the eyes, central nervous system, or any major surgery.

    • you have certain conditions such as:

      • stomach or intestinal bleeding or ulcers

      • bleeding in the lungs or kidneys, bladder or urethra

      • cerebral hemorrhage (bleeding in the brain)

      • heart infection

      • swelling of the heart membrane or fluid in the heart

      • a brain aneurysm (swelling of an artery that supplies blood to the brain).

    • you have any medical procedure that can increase the risk of bleeding, such as spinal puncture or spinal anesthesia.

    • you have severe uncontrolled high blood pressure.

    • you are allergic to warfarin or any of the other ingredients in COUMADIN (see What are the ingredients in COUMADIN?).

    • you consume alcohol.

    • you practice any activity or sport that may result in serious injury.

    • have psychosis (a mental disorder).

    Side Effects

    COUMADIN affects blood clotting, so most side effects are related to bleeding. COUMADIN can cause bleeding that can be serious and sometimes lead to death.

    Interactions with this medication

    The following prescription medicines may interact with COUMADIN:

    • Medicines to treat pain and inflammation called non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen, celecoxib, diclofenac and naproxen.

    • Blood thinners such as aspirin, clopidogrel, apixaban, rivaroxaban, dabigatran, ticagrelor, prasugrel and dipyridamole.

    • Antidepressants in the class called selective serotonin reuptake inhibitors (SSRI) such as sertraline, paroxetine, fluoxetine, escitalopram and citalopram.

    • Medicines to treat bacterial or antifungal infections such as amoxicillin, penicillin, azithromycin, ciprofloxacin, erythromycin, doxycycline, fluconazole, voriconazole and itraconazole.

    • Other medicines that contain warfarin. Warfarin is the active ingredient in COUMADIN.

    Natural health products that may interact with COUMADIN include:

    • bromelains

    • coenzyme Q10

    • danshen (Colocasia antiquorum)

    • dong quai (Angelica sinensia)

    • garlic

    • Ginkgo biloba

    • ginseng

    • St. John’s wort

    How COUMADIN may interact with food:

    • Eat a normal balanced diet. Avoid big changes in your diet. Talk to your healthcare professional before you go on a diet.

    • Eat a consistent amount of green, leafy vegetables. Do not make big changes in your diet. These vegetables have high amounts of Vitamin K. The amount of vitamin K in your daily diet may affect therapy with COUMADIN.

    • Tell your healthcare professional if cranberry juice or other cranberry products are part of your normal diet.

    Proper Use of this medication

    Take COUMADIN exactly the way your healthcare professional tells you and take it at the same time every day.

    • You can take COUMADIN either with food or on an empty stomach.

    • Your dosage may change from time to time depending on your response to COUMADIN.

    • Do not start, stop, or change any medicine except on advice of your healthcare professional.

    • The dose of COUMADIN may be different for each patient. For example, older patients (age 60 years of age or older) seem to respond more to COUMADIN. As your age increases, you may need a lower dose of COUMADIN. Your healthcare professional will monitor your INR levels and will decide what dose is best for you. This dose may change from time to time.

      Missed dose:

      • If you miss a dose of COUMADIN, notify your healthcare professional right away.

      • Take the dose as soon as possible on the same day.

      • Do not take a double dose of COUMADIN the next day to make up for a missed dose.

    Other related products

    The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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