Coumadin (Coumarin, Panwarfin, Warfarin Sodium)

Class of Drugs: Anticoagulant

Manufacturer: Bristol-Myers Squibb Company

Information on Patient Assistance Program:

The Partnership for Prescription Assistance -
1-888-4PPA-NOW (1-888-477-2669)
or
Bristol-Myers Squibb Patient Assistance Foundation, Inc.
PO Box 1058
Somerville, NJ 8876
(http://www.bmspaf.org/ - Web Site is not currently available)

Description: Tablets are dispensed with different colors for each dosage amount. The word "COUMADIN" and the dosage (in mg.) are imprinted on the tablet.

Ingredient: Warfarin Sodium

Use: Warfarin sodium is an anticoagulant that is often used in treating breast cancer related postmastectomy lymphedema

Warnings:

Avoid any activity or sport that may result in traumatic injury.

You must make sure that you doctor monitors your PT/INR (prothrombin time/International Normalized Ratio) or does other suitable coagulation tests. Travel, changes in diet, environment, physical state and medication may change the way your body reacts to an anticoagulant. If any other medications are prescribed, discontinued or taken irregularly it is a good idea too check your 'clotting time' (PT/INR).

An INCREASED PT/INR - the anticoagulant can makes your blood to 'thin' which may cause hemorrhage. This may occur because of changes in your metabolism due to cancer, congestive heart failure, diarrhea, elevated temperature, hepatic (liver) disorders, hyperthyroidism, poor nutrition, and vitamin K deficiency.

A DECREASED PT response may be caused by edema, hereditary warfarin resistance, hyperlipemia, hypothyroidism, nephritic (kidneys) syndrome.

Strict adherence to prescribed dosage schedule is necessary. Do not take ordiscontinue any other medication, except on advice of physician. Avoid alcohol consumption. Do not take warfarin sodium during pregnancy and do not become pregnant while taking it.

Special Risk Patients: Warfarin sodium is a narrow therapeutic range (index) drug, and caution should be observed when warfarin sodium is administered to certain patients such as the elderly or debilitated or when administered in any situation or physical condition where added risk of hemorrhage is present.

Side Effects: Notify your physician immediately if any unusual bleeding or symptoms occur. Signs and symptoms of bleeding include pain, swelling or discomfort, prolonged bleeding from cuts, increased menstrual flow or vaginal bleeding, nosebleeds or bleeding of gums from brushing, unusual bleeding, bruising, red or dark brown urine, red or tar black stools, headache, dizziness, or weakness. If therapy with warfarin sodium is discontinued the anticoagulant effects of warfarin sodium may persist for about 2 to 5 days.

Intramuscular (IM) injections of medications should be confined to the upper extremities which permits easy access for manual compression, inspections for bleeding and use of pressure bandages. Caution should be observed when warfarin sodium is administered concomitantly with nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, to be certain that no change in anticoagulation dosage is required.

There are many drug interactions that may cause complications when you are taking anticoagulants. Consult your doctor before taking ANY drug - especially an analgesic such as aspirin or Tylenol. There is real danger of hemorrhage or eliminating the benefit of the medication if you mix the wrong drugs.

Caution is recommended when taking other medications with warfarin sodium. When any medications are started or stopped, more frequent PT monitoring is advisable. It has been reported that concomitant administration of warfarin sodium and ticlopidine may be associated with cholestatic hepatitis.

Effect on Other Drugs: Warfarin sodium may also affect the action of other drugs. Hypoglycemic agents (chlorpropamide and tolbutamide) and anticonvulsants (phenytoin and phenobarbital) may accumulate in the body as a result of interference with either their metabolism or excretion.

In addition to specific drug interactions that might affect PT, NSAIDS, including aspirin, can inhibit platelet aggregation, and can cause gastrointestinal bleeding, peptic ulceration and/or perforation.

Warfarin sodium resistance should be suspected if large daily doses of warfarin sodium are required to maintain a patient's PT/INR within a normal therapeutic range.

Contact your doctor if any illness, such as diarrhea, infection or fever develops.

If you notice any other side effects, check with your doctor.

References: Coumadin (Coumarin, Panwarfin, Warfarin Sodium)

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This information is intended as reference and not as medical advice. All treatment decisions should be made with your team of medical professionals and prescriptions must be given by your doctor. See TERMS AND CONDITIONS.