Warfarin
Uses of Warfarin
Warfarin is one of the mainstay treatments in the management of conditions that are caused by blood clots and belongs to the group of anticoagulant medicines.
In addition to preventing blood clots in conditions such as atrial fibrillation and deep vein thrombosis, it is also used to manage pulmonary embolism and patients with prosthetic heart valves.
Side effects of Warfarin
Bleeding (e.g., nosebleeds, bleeding gums, heavy menstrual bleeding)
Jaundice
Diarrhoea
Nausea
Hair loss
How Warfarin works
Warfarin is an anticoagulant, which means it helps to prevent blood clots.
It acts by blocking the action of vitamin K, a substance that the body requires to produce certain proteins that allow the blood to clot. By inhibiting the synthesis of these vitamin K dependent clotting factors (II, VII, IX, X) and two anticoagulant proteins C and S, Warfarin prevents abnormal blood clot formation. This results in a longer time for the blood to clot and reduces the risk of harmful clots forming in the blood vessels, helping manage conditions like deep vein thrombosis and atrial fibrillation.
Certified content
Written By
Doctor of Medicine
Reviewed By
BMS, FMC, MD Resident
Expert Advice
Dosage Forms Available
Warfarin can be taken orally (tablet).
Age and Dose Restrictions
This medication is suitable for use by adults aged 18 and above.
Contraindications
This medication is contraindicated in patients with known allergies to Warfarin. It is also contraindicated in patients with active bleeding, severe liver or kidney disease, uncontrolled hypertension, and patients who have recently had a stroke, aneurysm, or bleeding in the brain.
Other Medications to Avoid
Warfarin may interact with salicylates (such as aspirin), NSAIDs (like ibuprofen and naproxen), antibiotics (such as ciprofloxacin and erythromycin) and anticonvulsants (such as carbamazepine).
Overdose and Missed Dose
An overdose of Warfarin can be life-threatening due to the increased risk of serious bleeding. If you suspect an overdose, seek immediate medical attention.
If you miss a dose of Warfarin, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to make up for a missed one.
Management of Side Effects
Most side effects are temporary and generally harmless and resolve when discontinuing this medicine. However, if you experience any severe side effects or worsening of any of the symptoms, please consult your doctor.
If you experience mild to moderate bleeding (such as nosebleeds or gum bleeding), applying pressure to the area may help.
If you experience nausea or vomiting, taking this medicine with food can help.
If you experience mild diarrhoea, ensure you stay hydrated by drinking plenty of fluids.
Use in Driving and Operating Machinery
Warfarin does not generally affect your ability to drive or operate heavy machinery. However, if you experience side effects like dizziness or fainting, avoid these activities.
Use in Pregnancy and Lactation
Warfarin can cause fetal harm and is contraindicated in pregnancy except in women with mechanical heart valves at high risk of thromboembolism.
Caution in Other Conditions
Patients with liver disease or kidney disease should use Warfarin with caution, as the medication is metabolised by the liver and eliminated by the kidneys. Individuals with a history of bleeding disorders should also exercise caution when using Warfarin due to the increased risk of bleeding.
Special Dietary and Lifestyle Recommendations
Maintain a consistent intake of vitamin K, as sudden changes can affect how Warfarin works in your body. Foods that are high in vitamin K include green leafy vegetables like kale and spinach.
Avoid activities that can increase your risk of bleeding or injury. Use caution with sharp objects like razors and nail cutters.
Frequently asked questions
What is the duration of treatment with Warfarin?
The duration of treatment with Warfarin varies based on the individual's condition and response to therapy. Some patients may be required to take it for a few weeks or months, while others may need lifelong therapy.
Does Warfarin have any effect on sleep?
Warfarin does not typically cause changes in sleep patterns. However, if you are experiencing sleep disturbances, it is important to consult your doctor as it might be related to other factors.
Will Warfarin affect fertility?
Warfarin does not affect fertility in men or women. However, if you are planning to conceive, it is crucial to discuss this with your doctor due to its potential risks during pregnancy.
Is it safe to take Warfarin daily?
Yes, it is safe for most patients to take Warfarin daily, as long as it is taken under the supervision of a doctor and regular blood tests are conducted to monitor its effect.
How much time does Warfarin take to work?
Warfarin generally begins to reduce the ability of the blood to clot within 24 hours after taking the dose; however, its full effects may not be seen until 72-96 hours after taking the medication.
What is the best time to take Warfarin?
Warfarin can be taken at any time of the day but should be taken at the same time each day for optimal effect. It can be taken with or without food.
Is Warfarin available over the counter, or do I need a prescription?
Warfarin is not available over the counter. It is a prescription medication and should be used under the supervision of a doctor.
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