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Warfarin-Oral - Patient Medicine Information

> Why do I need this medicine?
> How do I take this medicine?
> What should I do if I have forgotten to take this medicine?
> When should I not use this medicine?
> What should I take note of while taking this medicine?
> What side effects could I experience?
> Can I take this with other medicines?
> What special dietary instructions should I follow?
> How should I store this medicine?

 
Other Known Brands
  • Apo-Warfar    
  • Orfarin    

Why do I need this medicine?

Warfarin is a blood-thinning medicine. It prevents special cells in the blood from sticking to each other. This reduces the risk of harmful blood clots forming in the body. Blood clots that form in a blood vessel inside the heart or brain can cause a heart attack or a stroke.

This medicine is used to reduce the risk of stroke and heart attack in people who have a high risk of getting them. This includes people who have had a stroke or heart attack before and are at risk of getting another stroke or heart attack; and people with medical conditions that may increase their chances of getting them.

This medicine is also used to prevent blood clots in people with artificial heart valves or those with faulty heart valves.

Warfarin is also used to prevent blood clots from forming in the leg veins (deep vein thrombosis or DVT) and the vessels of the lungs (pulmonary embolism or PE).

How do I take this medicine?

Take Warfarin exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

You may take Warfarin with or without food. Try to take it at the same time each day.

This medicine must be taken regularly for it to be effective. Continue taking Warfarin even when you feel better. This medicine is not a cure for your condition and you may need to take it for an indefinite length of time. Do not stop taking Warfarin unless instructed by the doctor.

What should I do if I have forgotten to take this medicine?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to take your medicine, let your doctor and pharmacist know.

When should I not use this medicine?

Alert your doctor if you have:
  • bleeding disorders
  • stomach ulcers, especially if you have ever bled from a stomach ulcer
  • high blood pressure that is severe or not well-controlled
  • blood disorders
as Warfarin may not be suitable for you.

Do not take Warfarin if you are pregnant or planning to have a baby soon. If you become pregnant while being treated with this medicine, alert your doctor immediately. Warfarin may cause harm to your unborn child. Use proven birth control methods while being treated with this medicine. You may wish to discuss birth control methods with your doctor.

Let your doctor know if you have recently had a surgery or operation.

If you are going for an operation, including minor operations and dental work, first consult your doctor before going ahead with the operation or dental work. You must also inform the surgeon or dentist that you are taking Warfarin.

What should I take note of while taking this medicine?

Inform your doctor if you have:
  • liver disease
  • kidney disease
  • vitamin K deficiency
  • systemic infection
  • thyroid problems
You may bleed more easily and for a longer time than usual while you are being treated with Warfarin. Alert your doctor if you notice excessive bleeding.

Do not take part in activities in which you may fall or get injured, such as contact sports. Alert your doctor if you get any unusual bruising (large bruises or several bruises) or bleeding that takes a long time to stop (e.g. too much bleeding when you floss or brush your teeth).

Take special care when shaving or handling sharp objects to avoid cutting yourself. Use a soft toothbrush when brushing your teeth to reduce the risk of gum bleeding.

Carry identification stating that you are on Warfarin. Most hospitals and clinics will be able to provide you with such identification. Speak to your doctor about this.

Why do I need to have blood tests done so often?

For as long as you are taking Warfarin, you will need to have regular blood tests to check your body's response to the medicine. This blood test is called an INR (International Normalised Ratio). The INR measures how much time your blood takes to clot. Each person has his or her own target INR result. Your doctor will discuss with you about your target INR result.

You will need to have an INR blood test done more often in the first few days or weeks, so that your doctor can monitor your response to this medicine and a suitable Warfarin dose can be customised for you. This medicine doses will vary for different people as each person's physical condition is different.

Some genetic traits (CYP2C9 and VKORC1) can affect your response to Warfarin and may increase your risk for serious side effects. Your doctor may perform genetic testing before giving you this medicine or during early days of your therapy, to check if the dosage is suitable and effective for you.

Keep all appointments with your doctor as he needs to closely monitor your response to Warfarin and any side effects that this medicine may cause. Make sure you have your blood tests done as scheduled by the doctor.

What side effects could I experience?

Warfarin may cause any of the following side effects: loss of hair, rash, fever, diarrhoea, nausea and vomiting.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
  • unusual bleeding, especially excessive bleeding or bleeding that takes a long time to stop
  • gum or nose bleeding that takes a longer than usual time to stop
  • unusual bruises, especially if the bruises appear by themselves or if they cover a large area
  • heavier than usual menstrual flow or any other changes in the menstrual flow
  • nausea, vomiting, diarrhoea, fever or other signs of infection that last for 2 days or more
  • sticky, black or bloody bowel
  • blood in the urine (this usually shows as a dark tea colour)
  • cough out blood or phlegm that looks like coffee grounds
  • severe dizziness with tiredness, fever, headache and body pain
  • chest pain
  • difficulty breathing
  • severe headache with nausea or vomiting or confusion
  • swelling, pain or tenderness in the abdominal area
  • purple discolouration of the skin, especially around the toes, feet and legs
  • yellowing of the skin, eyes, pain near the stomach area
You should also let your doctor know if you fall or injure your head or back. Also alert your doctor if you have any severe or prolonged back pain that has no obvious cause.

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Can I take this with other medicines?

Inform your doctor and pharmacist if you are taking or have taken any of these medicines:
  • other blood thinning medicines as e.g. ticlopidine, clopidogrel, cilostazol, dipyridamole
  • allopurinol (a gout medicine)
  • gastric medicines e.g. cimetidine, omeprazole
  • medicines for heart disease e.g. amiodarone, propafenone
  • medicines to treat fungal infections e.g. itraconazole, fluconazole
  • antibiotics e.g. erythromycin, rifampicin
  • medicines for seizures epilepsy (seizures or fits) e.g. phenytoin, carbamazepine
  • medicines for pain and fever e.g. paracetamol (long-term use)
  • medicines for pain and inflammation (NSAIDs) e.g. diclofenac, mefenamic acid, ibuprofen, aspirin
  • cholesterol-lowering medicines e.g. fluvastatin, simvastatin, lovastatin, rosuvastatin, clofibrate
  • multivitamins containing vitamin K
  • St. John's wort (herbal medicine)
This list does not include all medicines that may interact with Warfarin.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.

What special dietary instructions should I follow?

Avoid alcohol.

Avoid taking unusually large amounts of food that is high in vitamin K. These include dark green vegetables, beef or pork liver and green tea. However, if it is your usual habit to take these foods, you may continue to do so. The key is to avoid sudden or drastic changes to your usual diet.

How should I store this medicine?

Store in a cool, dry place away from the reach of children.

Medicines must not be used past the expiry date.

This information is independently developed by MIMS based on Warfarin-Oral and is provided for your reference only. It is not a replacement for and should only be used in conjunction with full consultation with a licensed healthcare professional, the information provided by your pharmacist and/or the manufacturer of the medication. It may not contain all the available information you require and cannot substitute professional medical care, nor does it take into account all individual circumstances. Although great effort has been made to ensure content accuracy, we shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2019 MIMS. All rights reserved. Powered by MIMS.com

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