Warfarin

Molecule Description

Warfarin prevents the formation of clots in blood vessels and their migration a

long the blood flow to distant parts. It belongs to a class of medicines called anticoagulants.

Uses

Contraindications

Side effects

Precautions and Warnings

Uses of Warfarin

Atrial fibrillation (rapid, irregular heartbeats)
Rheumatic heart disease (disease of heart valves)
Deep Vein Thrombosis (DVT) (blood clots in deeper veins, usually the legs)
Pulmonary embolism (a blood clot passes along blood flow and blocks arteries that supply the lungs, most commonly from deep veins of the leg)
Transient Ischemic Attack (TIA) (clots in the blood vessels supplying the brain causing temporary damage)

Contraindications of Warfarin

When should one not use Warfarin

Allergy/ allergic reactions to Warfarin or any other ingredients of the medicine
Uncontrolled bleeding
Open wounds
Active ulcer disease; infection of the outer lining of the heart (pericarditis)
Rupture of blood vessels in the brain (haemorrhagic stroke)
Recent brain, eye or spinal cord injury or surgery (within 72 hours)
Liver or kidney disease
Uncontrolled hypertension
Any condition that causes easy bruising (Cushing’ syndrome, haemophilia, end-stage kidney disease, etc.)

Side effects of Warfarin

Common side effects of this drug are:

Unexplained bleeding from the nose
Black or red stools due to internal bleeding
Dark red or brown urine which may be due to your kidney or bladder conditions
Fever
Nausea and vomiting
Allergic reactions
Skin rashes & hair loss
Diarrhea
Purple discolouration of the skin (bruising)
Jaundice (yellowing of skin or white of eyes)
Changes in the quantity of urine you pass
Painful skin rash that may lead to severe complications (serious but rare)

Precautions and Warnings of Warfarin

Pregnancy

Can I take Warfarin during pregnancy?

Warfarin has the potential to cross the placental barrier and causes severe damage to the unborn baby and is not recommended during or if you are planning a pregnancy.

Breast Feeding

Can I take Warfarin while breastfeeding?

Warfarin does not pass into breast milk but caution is advised while breastfeeding. It is recommended that a woman who wishes to breastfeed while taking Warfarin should consult with a doctor.

Driving

Can I drive if I have consumed Warfarin?

Warfarin does not affect your driving ability.

Alcohol

Can I consume alcohol with Warfarin?

Large amounts of alcohol while may reduce Warfarin levels in the blood and hence occasional mild to moderate alcohol consumption is permitted.

Other General Warnings

Talk to your doctor if

You have blood disorders (such as anemia, hemophilia)
Bleeding problems (bleeding of the stomach/ intestines)
Bleeding in the brain
Blood vessel disorders (such as aneurysms)
Recent major injury/ surgery
Kidney and liver disease
Alcohol use
Mental/ mood disorders (including memory problems)
Frequent falls/ injuries, risk of haemorrhage (any clotting factor deficiency)
Ulcers in the stomach (or elsewhere)
Any planned surgeries or dental procedures
Thyroid disorders
To monitor prothrombin time (time taken for the blood to clot) in the initial days of starting the therapy

Mode of Action of Warfarin

How Does It Work?

Warfarin helps to keep blood flowing smoothly in your body by decreasing the amount of certain substances (clotting proteins) derived from Vitamin K in your blood. Effectively, Warfarin works by reduc...

Interactions of Warfarin

Interactions with other medicines

NSAIDs (painkillers) medications increases the risk of gastrointestinal bleeding
Other similar medicines that reduce clotting (Clopidogrel, Bivalirudin, Dabigatran, Dipyramidole, Fondaparinux, Rivaroxaban, Tirofiban, Abciximab, Prostacyclin, Aspirin, etc.)
Medicines that increase the effect of Warfarin (Allopurinol, Erlotinib, Disulfiram, Ketoconazole, Fluconazole Statins, Erythromycin, Metronidazole, Omeprazole, Amiodarone, pain killers, Zafirlukast)
Medicines that decrease the effect of Warfarin (Phenobarbital, Phenytoin, Carbamazepine, Griseofulvin, oral contraceptives, Rifampicin, Azathioprine, etc.)
Antidepressant medications (Fluoxetine, Paroxetine, Sertraline, Citalopram, Duloxetine, Venlafaxine, Desvenlafaxine, etc.)
Some HIV medicines (Protease inhibitors - Nelfinavir, Ritonavir)
Corticosteroids (Prednisolone, Betamethasone, Triamcinolone, etc.)
Fibrinolytic drugs (Streptokinase, Alteplase)
Other medicine used to prevent or treat clot formation

Interactions with food items

Warfarin can be taken without regard to food – before or after meals.

Dietary Restrictions of Warfarin

Foods rich in Vitamin K include beef liver, broccoli, sprouts, cabbage, soya beans, spinach may interact with Warfarin
Drinking cranberry juice or taking other cranberry products (for example capsules or concentrates), might increase Warfarin’s “thinning” effect of the blood
Limit intake of garlic, ginger, gingko (used for mental disorders) and horse chestnut (used for healthy veins)

Dosage of Warfarin

Overdose

If you take an overdose of Warfarin, the complications may be fatal. Speak to your doctor immediately. Depending on your condition and overdosage, you may require hospital admission for treatment and ...

Missed a Dose

Take the missed dose as early as you remember. Skip the dose if it is almost time for your next scheduled dose. Do not take two doses in a day to compensate the missed dose as the complications can be...

Content Details

WRITTEN BY

Dr. Ravi Kakarla

MBBS, MBA

REVIEWED BY

Dr. Ritu Budania

MBBS, MD (Pharmacology)

Frequently Asked Questions (FAQs)

Q: What is the best time to take Warfarin?

A: Warfarin can be taken at any time before or after meals but it is usually preferred in the evening. This is because the prothrombin test (to check the time taken for the blood to clot) is generally performed in the early morning and if a dose change is required, it can be done the same day after the blood test result.

Q: How to store this medicine?

A: Store in a cool dark place (not above 25-degree Celcius), in original package out of reach of children and pets. Check the expiry date at the time of buying.

References

Last Updated on: 05 Oct 2020 | 10:47 PM (IST)

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