Warfarin tablets

Composition 

1 tablet contains warfarin sodium 2.5 mg 

auxiliary substances: lactose, corn starch, calcium hydrogen phosphate dihydrate, Indigo, povidone 30, magnesium stearate

Packaging

50 or 100 PCs

Pharmacological action

With warfarin belongs to the group of anticoagulants — drugs that prevent blood clotting, and is intended for long-term use. Has an indirect anticoagulant effects inhibiting liver synthesis of factors involved in the regulation of blood coagulation. Warfarex prevents formation of new clots and prevent growth of already formed.

Testimony

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

• deep vein thrombosis,
• thromboembolism of the lungs,
• atrial fibrillation,
• myocardial infarction,
• prosthetic heart valves.

Contraindications

• hypersensitivity to Warfarin,
• bleeding (or the threat of their development) in some severe diseases,
• bacterial endocarditis,
• severe failure and severe liver disease or kidney
• obstructive jaundice,
• diabetes,
• acute DIC-syndrome,
• deficiency of proteins C and S,
• hemorrhagic diathesis,
• thrombocytopenia,
• ulcers disease stomach and duodenal ulcer in the acute stage,
• bleeding in the brain,
• alcoholism,
• severe arterial hypertension,
• recent or anticipated complex surgery and diagnostic procedures
• inadequate assessment of blood coagulation by laboratory methods
• the children’s age.

Application of pregnancy and breastfeeding

Warfarin should not be prescribed to pregnant women in connection with the revealed teratogenic, development of bleeding in the fetus and its death. The drug is excreted in breast milk in small amounts and has little to no effect on blood coagulation in a child, so this medication can be used during lactation, however, it is advisable to refrain from breastfeeding in the first 3 days of therapy with warfarin.

Method of application and doses

Inside, 1 times a day, preferably at the same time. Dose, mode and duration of application of Warfarex doctor determines for each patient individually, guided by the severity of the disease and results of the control of blood coagulation (INR). Without a doctor can not arbitrarily change the dose or stop treatment with Warfarin. Initial dose 2.5–5 mg per day in the first 2 days, then gradually adjust in accordance with the individual response of blood clotting of the patient (INR). After achieving the desired level of INR (2.0 to 3.0, and in some cases to 3.0–4.5) prescribe a maintenance dose. Elderly, weak or at-risk patients are prescribed a lower starting dose and cautious in their increase. Children Warfarex is not usually prescribed. At the beginning of treatment laboratory control of INR is carried out every day for the next 3-4 weeks control is carried out 1-2 times a week, and later every 1-4 weeks. More frequent additional monitoring is required in cases when the health of the patient before the scheduled surgery or other procedure, as well as when to prescribe or cancel any other drug.

Special instructions

The use of anticoagulants increases the risk of bleeding. To monitor the status of blood coagulation, during treatment with Warfarin should regularly visit a doctor and carry out the necessary tests. When referring to doctors, dentists or pharmacists you must tell them You are taking Warfarin. You should consult a doctor, if there are digestive disorders accompanied by diarrhoea (diarrhea), fever. Pregnancy during treatment with Warfarin is highly undesirable, therefore you must use effective methods of preventing it. You must be careful when handling sharp and traumatic objects, to avoid activities associated with the risk of injury and subsequent bleeding. During treatment should refrain from the use of ethanol (the risk gipoprotrombinemii). The safety of the drug in children in clinical trials has not been studied. Data regarding the adverse impact of Warfarin on the ability to drive vehicles and maintain other mechanism.

Drug interactions

High content of vitamin K in foods (spinach, broccoli, lettuce and other leafy vegetables) may reduce the effect of Warfarin. However, you should not change the diet too fast, use vitamins and nutritional supplements without consulting a 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, inhibitors of cytochrome P450, cimetidine, chloramphenicol, laxatives — increase the risk of bleeding. Avoid concomitant use of these drugs and Warfarin (cimetidine can be replaced with ranitidine or famotidine). If necessary, treatment with chloramphenicol anticoagulant therapy may be temporarily discontinued. Diuretics can reduce the effects of anticoagulants (in the case of hypovolemic Express actions, which may lead to increased concentration of clotting factors). Weaken the effect: barbiturates, vitamin K, glutetimid, griseofulvin, dicloxacillin, carbamazepine, mianserin, paracetamol, retinoid, rifampicin, sucralfate, phenazone, cholestyramine. Enhance the effect: allopurinol, amiodarone, anabolic steroids (alkylated at position C-17), acetylsalicylic acid and other NSAIDs, heparin, glibenclamide, glucagon, danazol, diazoxide, disopyramide, disulfiram, isoniazid, ketoconazole, clarithromycin, clofibrate, levamisole, metronidazole, miconazole, nalidixic acid, nilutamide, omeprazole, paroxetine, proguanil, oral hypoglycemic agent — derivatives of sulfonamides, sulfonamides, tamoxifen, thyroxine, quinine, quinidine, fluvoxamine, fluconazole, fluorouracil, chinolone, chloral hydrate, chloramphenicol, cephalosporins, cimetidine, erythromycin, ethacrynic acid, ethanol. When using Warfarin in combination with the above drugs is necessary to monitor INR at the beginning and end of the treatment and, if possible, 2-3 weeks from start of therapy. When using drugs that may increase the risk of bleeding due to the decrease in the normal coagulation (inhibition of blood clotting factors or liver enzymes), strategy, anticoagulant therapy should be determined by possibility of carrying out of laboratory control. If possible frequent laboratory monitoring, when necessary, treatment such means the dose of Warfarin can be reduced by 5-10%. If laboratory control is difficult, treatment with Warfarin must be discontinued if necessary, the appointment of these drugs.

Overdose

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

Treatment: for minor bleeding, reduce dose or stop treatment for a short period. In case of severe bleeding, transfusion of factor concentrates prothrombin complex or fresh frozen plasma, or whole blood.

Storage conditions

In protected from light place, at temperature not above 25 °C.

Shelf life

5 years.