Coumadin (Warfarin) Drug Information

  • Why is this medication prescribed?

    Coumadin (warfarin) is used to prevent blood clots from forming or growing larger in your blood and blood vessels. It is prescribed for people with certain types of irregular heartbeat, people with prosthetic (replacement or mechanical) heart valves, and people who have suffered a heart attack. Coumadin (warfarin) is also used to treat or prevent venous thrombosis (swelling and blood clot in a vein) and pulmonary embolism (a blood clot in the lung). Coumadin (warfarin) is in a class of medications called anticoagulants ('blood thinners'). It works by decreasing the clotting ability of the blood.

  • How should this medicine be used?

    Coumadin (warfarin) comes as a tablet to take by mouth. It is usually taken once a day with or without food. Take Coumadin (warfarin) at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Coumadin (warfarin) exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Call your doctor immediately if you take more than your prescribed dose of Coumadin (warfarin).

    Your doctor will probably start you on a low dose of Coumadin (warfarin) and gradually increase or decrease your dose based on the results of your blood tests. Make sure you understand any new dosing instructions from your doctor.

    Your doctor will probably start you on a low dose of Coumadin (warfarin) and gradually increase or decrease your dose based on the results of your blood tests. Make sure you understand any new dosing instructions from your doctor.

  • Other uses for this medicine

    This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

  • What special precautions should I follow?

    Before taking Coumadin (warfarin):

    • tell your doctor and pharmacist if you are allergic to Coumadin (warfarin) or any other medications.
    • do not take two or more medications that contain Coumadin (warfarin) at the same time. Be sure to check with your doctor or pharmacist if you are uncertain if a medication contains Coumadin (warfarin) or Coumadin (warfarin) sodium.
    • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take, especially antibiotics; aspirin or aspirin-containing products and other nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); heparin; medications for cancer, cholesterol, colds and allergies, depression, diabetes, digestive problems (including ulcers and heartburn), gout, heart disease, mental illness, pain,seizures, thyroid problems, and tuberculosis; oral contraceptives (birth control pills); streptokinase; ticlopidine; or urokinase. Many other medications may also interact with Coumadin (warfarin), so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. Do not take any new medications or stop taking any medication without talking to your doctor.
    • tell your doctor and pharmacist what herbal or botanical products you are taking, especially bromelains, coenzyme Q10 (Ubidecarenone), cranberry products, danshen, dong quai, garlic, Ginkgo biloba, ginseng, and St. John's wort. There are many other herbal or botanical products which might affect your body's response to Coumadin (warfarin).Do not start or stop taking any herbal products without talking to your doctor.
    • tell your doctor if you have or have ever had a thyroid condition or diabetes. Also tell your doctor if you have an infection, a gastrointestinal illness such as diarrhea, or sprue (an allergic reaction to protein found in grains that causes diarrhea), or an indwelling catheter (a flexible plastic tube that is placed into the bladder to allow the urine to drain out).
    • Tell your doctor if you are pregnant, think you might be pregnant, or plan to become pregnant while taking Coumadin (warfarin). You should not take Coumadin (warfarin) if you are pregnant. Talk to your doctor about the use of effective birth control while taking Coumadin (warfarin). If you become pregnant while taking Coumadin (warfarin), call your doctor immediately. Coumadin (warfarin) may harm the fetus.
    • tell your doctor if you are breast-feeding.
    • if you are having surgery, including dental surgery, or any type of medical or dental procedure, tell the doctor or dentist that you are taking Coumadin (warfarin). Your doctor may tell you to stop taking Coumadin (warfarin) before the surgery or procedure or change your dosage of Coumadin (warfarin) before the surgery or procedure. Follow your doctor's directions carefully and keep all appointments with the laboratory if your doctor orders blood tests to find the best dose of Coumadin (warfarin) for you.
    • tell your doctor if you drink or have ever drunk large amounts of alcohol. Your doctor will probably tell you not to take Coumadin (warfarin). Avoid drinking alcohol while you are taking this medication.
    • If you are going to receive an immunization, such as a flu shot, or any other injection into a muscle, tell the health care professional that you are taking Coumadin (warfarin).
  • What special dietary instructions should I follow?

    Eat a normal, healthy diet with the same amount of foods that contain vitamin K; ask your doctor or pharmacist for a list of foods that contain vitamin K. Be sure to talk to your doctor before you make any changes in your diet or try to gain or lose weight. Do not eat large amounts of leafy, green vegetables or certain vegetable oils, such as soybean or canola, that contain large amounts of vitamin K. Avoid juice or products that contain cranberries. Ask your doctor about eating licorice while taking Coumadin (warfarin).

    Tell your doctor if you drink nutritional supplements or receive supplements by a feeding tube.

  • What should I do if I forget a dose?

    Take the missed dose as soon as you remember it, if it is the same day that you were to take the dose. Do not take a double dose the next day to make up for a missed one. Talk to your doctor if you miss a dose of Coumadin (warfarin).

  • What side effects can this medication cause?

    Coumadin (warfarin) may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

    • gas
    • change in the way things taste
    • tiredness
    • pale skin
    • loss of hair
    • feeling cold or having chills

    If you experience any of the following symptoms, or those listed in the IMPORTANT WARNING section, call your doctor immediately:

    • hives
    • rash
    • itching
    • difficulty breathing or swallowing
    • swelling of the face, throat, tongue, lips, or eyes
    • hoarseness
    • chest pain or pressure
    • swelling of the hands, feet, ankles, or lower legs
    • fever
    • infection
    • nausea
    • vomiting
    • diarrhea
    • loss of appetite
    • pain in the upper right part of the stomach
    • yellowing of the skin or eyes
    • flu-like symptoms
    • joint or muscle pain
    • difficultly in moving any part of your body
    • feelings of numbness, tingling, pricking, burning, or creeping on the skin
    • painful erection of the penis that lasts for hours

    You should know that Coumadin (warfarin) may cause necrosis or gangrene (death of skin or other body tissues). Call your doctor immediately if you notice a purplish or darkened color to your skin, skin changes, ulcers, or an unusual problem in any area of your skin or body, or if you have a severe pain that occurs suddenly, or color or temperature change in any area of your body. Call your doctor immediately if your toes become painful or become purple or dark in color. You may need medical care right away to prevent amputation (removal) of your affected body part.

    Coumadin (warfarin) may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

  • What storage conditions are needed for this medicine?

    Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat, moisture (not in the bathroom), and light. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

  • In case of emergency/overdose

    In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

    Symptoms of overdose may include:

    • bloody or red, or tarry bowel movements
    • spitting or coughing up blood
    • heavy bleeding with your menstrual period
    • pink, red, or dark brown urine
    • coughing up or vomiting material that looks like coffee grounds
    • small, flat, round red spots under the skin
    • unusual bruising or bleeding
    • continued oozing or bleeding from minor cuts
  • What other information should I know?

    Carry an identification card or wear a bracelet stating that you take Coumadin (warfarin). Ask your pharmacist or doctor how to obtain this card or bracelet. List your name, medical problems, medications and dosages, and doctor's name and telephone number on the card.

    Tell all your healthcare providers that you take Coumadin (warfarin).

    Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

    It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

  • Brand Names

    • Coumadin®
    • Jantoven®