Coumadin (Warfarin tablet)

What is this medicine?

WARFARIN is an anticoagulant. It is used to treat or prevent clots in the veins, arteries, lungs or heart.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• alcoholism
• anemia
• blood disease, bleeding disorders, hemorrhage, hemophilia or aneurysm
• bowel disease, diverticulitis, or ulcers
• cancer
• diabetes
• heart disease
• heart valve infection
• high blood pressure
• history of bleeding in the gastrointestinal tract
• history of stroke or other brain injury or disease
• kidney or liver disease
• older than 65 years
• protein or vitamin deficiency
• psychosis or dementia
• recent surgery or injury
• an unusual or allergic reaction to warfarin, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. You can take this medicine with or without food. Take your medicine at regular intervals. Do not take it more often than directed. Do not stop taking except on the advice of your doctor or health care professional.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, call your healthcare provider. Take the dose as soon as possible on the same day. If it is almost time for your next dose, take only that dose. Do not take double or extra doses to make up for a missed dose.

What may interact with this medicine?

Do not take this medicine with any of the following medications:

• agents that prevent or dissolve blood clots
• aspirin or other salicylates
• danshen
• dextrothyroxine
• mifepristone
• St. John's Wort
• red yeast rice

This medicine may also interact with the following medications:

• acetaminophen
• agents that lower cholesterol
• alcohol
• allopurinol
• amiodarone
• antibiotics or medicines for treating bacterial, fungal or viral infections
• azathioprine
• barbiturate medicines for inducing sleep or treating seizures
• certain medicines for diabetes
• certain medicines for heart rhythm problems
• certain medicines for high blood pressure
• chloral hydrate
• cisapride
• disulfiram
• female hormones, including contraceptive or birth control pills
• general anesthetics
• herbal or dietary products like cranberry, garlic, ginkgo, ginseng, green tea, or kava kava
• influenza virus vaccine
• male hormones
• medicines for mental depression or psychosis
• medicines for some types of cancer
• medicines for stomach problems
• methylphenidate
• NSAIDs, medicines for pain and inflammation, like ibuprofen or naproxen
• propoxyphene
• quinidine, quinine
• raloxifene
• seizure or epilepsy medicine like carbamazepine, phenytoin, and valproic acid
• steroids like cortisone and prednisone
• tamoxifen
• thyroid medicine
• tramadol
• vitamin c, vitamin e, and vitamin K
• zafirlukast
• zileuton

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. You will need to have your blood checked regularly to make sure you are getting the right dose of this medicine. When you first start taking this medicine, these tests are done often. Once the correct dose is determined and you take your medicine properly, these tests can be done less often.

While you are taking this medicine, carry an identification card with your name, the name and dose of medicine being used, and the name and phone number of your doctor or health care professional or person to contact in an emergency.

You should discuss your diet with your doctor or health care professional. Many foods contain high amounts of vitamin K, which can interfere with the effect of this medicine. Your doctor or health care professional may want you to limit your intake of foods that contain vitamin K. Foods that have moderate to high amounts of vitamin K include brussel sprouts, kale, green tea, asparagus, avocado, broccoli, cabbage, cauliflower, collard greens, liver, soybean oil, soybeans, certain beans, mustard greens, peas (black eyed peas, split peas, chick peas), turnip greens, parsley, green onions, spinach, and lettuce.

This medicine can cause birth defects or bleeding in an unborn child. Women of childbearing age should use effective birth control while taking this medicine. If a woman becomes pregnant while taking this medicine, she should discuss the potential risks and her options with her health care professional.

Avoid sports and activities that might cause injury while you are using this medicine. Severe falls or injuries can cause unseen bleeding. Be careful when using sharp tools or knives. Consider using an electric razor. Take special care brushing or flossing your teeth. Report any injuries, bruising, or red spots on the skin to your doctor or health care professional.

If you have an illness that causes vomiting, diarrhea, or fever for more than a few days, contact your doctor. Also check with your doctor if you are unable to eat for several days. These problems can change the effect of this medicine.

Even after you stop taking this medicine, it takes several days before your body recovers its normal ability to clot blood. Ask your doctor or health care professional how long you need to be careful. If you are going to have surgery or dental work, tell your doctor or health care professional that you have been taking this medicine.

What side effects may I notice from this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• back or stomach pain
• chest pain or fast or irregular heartbeat
• difficulty breathing or talking, wheezing
• dizziness
• fever or chills
• headaches
• heavy menstrual bleeding or vaginal bleeding
• nausea, vomiting
• painful, blue, or purple toes
• painful, prolonged erection
• prolonged bleeding from cuts
• signs and symptoms of bleeding such as bloody or black, tarry stools, red or dark-brown urine, spitting up blood or brown material that looks like coffee grounds, red spots on the skin, unusual bruising or bleeding from the eye, gums, or nose
• skin rash, itching or skin damage
• unusual swelling or sudden weight gain
• unusually weak or tired
• yellowing of skin or eyes

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• diarrhea
• unusual hair loss

This list may not describe all possible side effects.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Protect from light. Throw away any unused medicine after the expiration date.