Apo-Warfarin

Warfarin Na

Prophylaxis &/or treatment of venous thrombosis & its extension, pulmonary embolism, atrial fibrillation w/ embolisation &/or cardiac valve replacement. To reduce the risk of death, recurrent MI & thromboembolic events eg stroke or systemic embolization after MI in patient w/ poor LV function.

Individualised dosage adjusted according to PT/INR. Initially, 2-5 mg daily. Maintenance: 2-10 mg daily.

May be taken with or without food.

Hypersensitivity. Haemorrhagic tendencies or blood dyscrasias; recent or contemplated surgery of CNS, eye & traumatic surgery resulting in large open surfaces; bleeding tendencies associated w/ active ulceration or overt bleeding of GI, GUT or resp tract, cerebrovascular haemorrhage, aneurysms (cerebral, dissecting aorta), pericarditis & pericardial effusions, bacterial endocarditis; threatened abortion, eclampsia & preeclampsia. Inadequate laboratory facilities. Unsupervised patients w/ senility, alcoholism, psychosis or inability to cooperate. Spinal puncture & other diagnostic or therapeutic procedures w/ potential for uncontrollable bleeding. Major regional, lumbar block anaesth, malignant hypertension. Concomitant use w/ streptokinase or urokinase. Pregnancy. Women of childbearing potential.

Presence of any predisposing condition where added risk of haemorrhage or necrosis is present. Heparin-induced thrombocytopenia & DVT. Severe to moderate hepatic or renal insufficiency, infectious diseases or disturbances of intestinal flora (sprue, antibiotic therapy), trauma which may result in internal bleeding. Surgery or trauma resulting in large exposed raw surfaces. Indwelling catheters. Severe to moderate HTN, known or suspected deficiency in protein C-mediated anticoagulant response. Topical prep containing methyl salicylate. Perform periodic determination of PT/INR or other suitable coagulation test. Lactation. Childn <18 yr. Elderly or debilitated patients

Fatal or nonfatal hemorrhage; hypersensitivity/allergic reactions, systemic cholesterol microembolization, purple toes syndrome, hepatitis, cholestatic hepatic injury, jaundice, elevated liver enzymes, vasculitis, edema, fever, rash, dermatitis including bullous eruptions, urticaria, abdominal pain including cramping, flatulence/bloating, fatigue, lethargy, malaise, asthenia, nausea, vomiting, diarrhea, pain, headache, dizziness, taste perversion, pruritus, alopecia, cold intolerance & paresthesia including feeling cold & chills.

Increase & decrease PT/INR response w/ antiarrhythmics, antibiotics, anticonvulsants, antidepressants, antineoplastics, antithyroid drugs, diuretics, systemic fungal medications, gastric acidity & peptic ulcer agents, hypnotics, hypolipidemics, adrenocortical steroids, TB agents, vit K, alcohol, chloral hydrate, cholestyramine, cyclophosphamide, methimazole, moricizine HCl, phenytoin, prednisone, propylthiouracil, ranitidine. Concomitant administration w/ ticlopidine may be associated w/ cholestatic hepatitis. Increase effects w/ botanical (herb) medicines [eg bromelains, danshen, dong quai (Angelica sinensis), garlic, ginkgo biloba, ginseng]; decrease w/ coenzyme Q₁₀ (ubidecarenone) & St. John's wort. Hypoglycaemic agents (chlorpropamide & tolbutamide) & anticonvulsants (phenytoin & phenobarb). Inhibit platelet aggregation & can cause GI bleeding, peptic ulceration &/or perforation w/ NSAIDs including aspirin.

Anticoagulants, Antiplatelets & Fibrinolytics (Thrombolytics)

B01AA03 - warfarin ; Belongs to the class of vitamin K antagonists. Used in the treatment of thrombosis.

POM