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)

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.)

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)

Other General Warnings

• 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

How Does It Work?

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

Overdose

Missed a Dose