Warfarin Canon, tablets 2.5mg 100 pcs

Warfarin s 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 in the liver the synthesis of a number of factors involved in the regulation of blood clotting.

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

Indications

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

Active ingredient

Composition

1 tablet contains warfarin sodium 2.5 mg;

excipients:

lactose;

corn starch;

calcium hydrophosphate dihydrate;

indigo carmine;

povidone 30;

Magnesium stearate.

How to take, the dosage

Ingestion, once a day, preferably at the same time of day. The doctor determines the dose, regimen and duration of Warfarex for each patient individually, guided by the severity of the disease and the results of clotting control (INR). It is not allowed to change dose or stop treatment with Varfarin without doctor’s permission.

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

Elderly, frail, or at-risk patients are prescribed lower starting doses and are cautious about increasing them.

In children, Warfarex is not usually prescribed. At the beginning of treatment laboratory INR control is performed every day, during the next 3-4 weeks the control is performed 1-2 times a week, later – every 1-4 weeks.

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 cancelled.

Interaction

High levels of vitamin K in foods (spinach, broccoli, lettuce, and other leafy vegetables) can reduce the effects of Warfarin. However, you should not change your diet too drastically or use vitamins or supplements without consulting your doctor. Smoking may reduce the anticoagulation 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.

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

Diuretics may decrease the effect of anticoagulants (in case of marked hypovolemic effect, which may lead to increased concentration of clotting factors).

Weaken the effect of: barbiturates, vitamin K, glutethimide, griseofulvin, dicloxacillin, carbamazepine, mianserine, paracetamol, retinoids, rifampicin, sucralfate, phenazone, cholestyramine.

The effects are enhanced by: 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 agents – sulfonamide derivatives, sulfonamides, tamoxifen, thyroxine, quinine, quinidine, fluvoxamine, fluconazole, fluorouracil, quinolones, chloral hydrate, chloramphenicol, cephalosporins, cimetidine, erythromycin, etacrynic acid, ethanol.

When using Warfarin in combination with the above drugs, INR should be monitored at the beginning and end of treatment and, if possible, 2-3 weeks from the beginning of therapy.

When using drugs that may increase the risk of bleeding due to decreased normal coagulation (inhibition of 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, the dose of warfarin can be reduced by 5-10% if therapy with such agents is necessary. If laboratory monitoring is difficult, Warfarin therapy should be discontinued if the above drugs are necessary.

Special Instructions

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

When visiting doctors, dentists, or pharmacists, you should tell them that you are taking Warfarin. You should see a doctor if digestive disorders appear accompanied by diarrhea (diarrhea), fever.

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

Please be careful when handling sharp and traumatic objects, avoid activities associated with the risk of injury and subsequent bleeding.

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

Contraindications

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 common: increased bleeding.

Often: increased sensitivity to warfarin after long-term use.

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

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

Overdose

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

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

Pregnancy use

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

The drug is excreted with mother’s milk in insignificant amount and has almost no effect on blood clotting in a child, therefore the drug can be used during lactation, but it is advisable to refrain from breast-feeding during first 3 days of warfarin therapy.