Warfarin, pills 2.5 mg 100 pcs.

Composition

1 tablet contains warfarin sodium 2.5 mg;

excipients:

lactose;

corn starch;

calcium hydrophosphate dihydrate;

indigo carmine;

povidone 30;

magnesium stearate.

Pharmacological action

Warfarin c belongs to the group of anticoagulants-drugs that prevent blood clotting, and is intended for long-term use.

It has an indirect anticoagulant effect, inhibiting the synthesis of a number of factors involved in the regulation of blood clotting in the liver.

Warfarex prevents the formation of new blood clots and prevents the increase of already formed ones.

Indications

Prevention and treatment of diseases caused by the formation of blood clots in blood vessels:

• deep vein thrombosis;
• pulmonary embolism;
• atrial fibrillation;
• myocardial infarction;
• prosthetic heart valves.

Use during pregnancy and lactation

Warfarin should not be prescribed to pregnant women due to the identified teratogenic effect, the development of bleeding in the fetus and its death.

The drug is excreted in breast milk in small amounts and has virtually no effect on blood clotting in the child, so this medicine can be used during lactation, but it is advisable to refrain from breastfeeding in the first 3 days of warfarin therapy.

Contraindications

• hypersensitivity to Warfarin;
• bleeding (or the threat of its development) under certain severe diseases;
• bacterial endocarditis;
• severe failure and severe liver disease or kidney disease;
• obstructive jaundice;
• diabetes mellitus;
• acute DIC;
• deficiency of proteins C and S;
• hemorrhagic diathesis;
• thrombocytopenia;
• ulcer disease of stomach and duodenum in the acute phase;
• bleeding in the brain;
• alcoholism;
• severe hypertension;
• recent or anticipated complex operations and diagnostic procedures;
• inadequate assessment of blood coagulation by laboratory methods;
• children’s age.

Side effects

Frequency: very often-more than 1/10, often-more than 1/100 and less than 1/10, infrequently-more than 1/1000 and less than 1/100, rarely-more than 1/10000 and less than 1/1000.

Very often: increased bleeding.

Often: increased sensitivity to warfarin after prolonged use.

Infrequently: anemia, vomiting, abdominal pain, nausea, diarrhea.

Rare: eosinophilia, increased activity of “liver” enzymes, jaundice, rash, urticaria, pruritus, eczema, skin necrosis, vasculitis, hair loss, nephritis, urolithiasis, tubular necrosis, palmar-plantar syndrome.

Interaction

High levels of vitamin K in foods such as spinach, broccoli, lettuce, and other leafy vegetables can reduce the effects of Warfarin. However, you should not change the nature of the diet too dramatically, use vitamins and dietary supplements without consulting your doctor. Smoking can reduce the anticoagulant effect of the drug. The effect of Warfarin may change under the influence of a large number of drugs. NSAIDs, dipyridamole, valproic acid, cytochrome P450 inhibitors, cimetidine, chloramphenicol, laxatives-increase the risk of bleeding.

The combined use of these drugs and Warfarin should be avoided (cimetidine can be replaced with ranitidine or famotidine). If treatment with chloramphenicol is necessary, anticoagulant therapy may be temporarily discontinued.

Diuretics can reduce the effect of anticoagulants (in the case of severe hypovolemic action, which can lead to an increase in the concentration of clotting factors).

Reduce the effect of: barbiturates, vitamin K, glutetimide, griseofulvin, dicloxacillin, carbamazepine, mianserin, paracetamol, retinoids, rifampicin, sucralfate, phenazone, cholestyramine.

Enhance the effect of: allopurinol, amiodarone, anabolic steroids (alkylated in position C-17), acetylsalicylic acid and other NSAIDs, heparin, glibenclamide, glucagon, danazol, diazoxide, disopyramide, disulfiram, isoniazid, ketoconazole, clarithromycin, clofibrate, levamizole, metronidazole, miconazole, nalidixic acid, nilutamide, omeprazole, paroxetine, proguanil, oral hypoglycemic agents — derivatives of sulfonamides, sulfonamides, tamoxifen, thyroxine, quinine, quinidine, fluvoxamine, fluconazole, fluorouracil, quinolones, chloral hydrate, chloramphenicol, cephalosporins, cimetidine, erythromycin, ethacric acid, ethanol.

When using Warfarin in combination with the above drugs, it is necessary to monitor INR at the beginning and end of treatment and, if possible,2-3 weeks after the start of therapy.

When using drugs that may increase the risk of bleeding due to a decrease in normal coagulation (inhibition of blood clotting factors or liver enzymes), the strategy of anticoagulant therapy should be determined by the possibility of laboratory monitoring.

If frequent laboratory monitoring is possible, then if therapy with such agents is necessary, the dose of Warfarin can be reduced by 5-10%. If laboratory monitoring is difficult, then treatment with Warfarin should be discontinued if it is necessary to prescribe these drugs.

How to take, course of administration and dosage

Inside,1 time a day, preferably at the same time of day. The doctor determines the dose, mode and duration of use of Warfarex for each patient individually, based on the severity of the disease and the results of blood clotting control (INR). Without the doctor’s permission, you can not change the dose or stop treatment with Warfarin without permission.

The initial dose is 2.5-5 mg per day for the first 2 days, then it is gradually adjusted according to the individual patient’s blood clotting response (INR). After reaching the desired INR level (2.0–3.0, and in some cases 3.0–4.5), a maintenance dose is prescribed.

Elderly, debilitated, or at-risk patients should be given lower initial doses and caution should be exercised when increasing them.

Children are not usually prescribed Warfarex. At the beginning of treatment, laboratory monitoring of INR is carried out every day, during the next 3-4 weeks, monitoring is carried out 1-2 times a week, and later-every 1-4 weeks.

More frequent additional monitoring is necessary when the patient’s health condition changes, before a planned operation or other procedure, or when any other medication is prescribed or canceled.

Overdose

Symptoms of chronic intoxication: bleeding from the gums, nosebleeds, excessive menstrual bleeding, heavy or prolonged bleeding with small superficial injuries, skin hemorrhages, the presence of blood in the urine and feces, etc.

Treatment: in case of minor bleeding, it is necessary to reduce the dose of the drug or stop treatment for a short period of time. In case of severe bleeding — transfusion of concentrates of prothrombin complex factors, or fresh frozen plasma, or whole blood.

Special instructions

The use of anticoagulants increases the risk of bleeding. To monitor the state of the blood coagulation system, during treatment with Warfarin, you should regularly visit your doctor and perform the prescribed tests.

When contacting your doctors, dentists, or pharmacists, you should inform them that you are taking Warfarin. You should consult a doctor if digestive disorders occur, accompanied by diarrhea (diarrhea), fever.

Pregnancy during Warfarin treatment is highly undesirable, so it is necessary to use effective methods to prevent it.

It is necessary to be careful when handling sharp and traumatic objects, avoid activities that involve the risk of injury and subsequent bleeding.

During treatment, it is necessary to refrain from using ethanol (risk of hypoprothrombinemia). The safety of using the drug in children in clinical studies has not been sufficiently studied. There are no data on the adverse effects of Warfarin on the ability to drive vehicles and maintain other mechanisms.

Form of production

Pills.

Storage conditions

Store in a dry place, protected from light, at a temperature not exceeding 25 °C

Shelf life

2 years

Active ingredient

Warfarin

Conditions of release from pharmacies

By prescription

Dosage form

of the tablet

Purpose

Adults on doctor’s prescription, Nursing mothers

Indications

Prevention of thrombosis, Prevention of thromboembolism, Prevention of acute myocardial infarction, Prevention of heart attacks and strokes

Weight

Weight: 39 gr.