Coumadin Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Coumadin Tablet contains warfarin sodium, a coumarin and indandione classified as a vitamin K antagonist. It is a prescription anticoagulant, or blood thinner, used to treat blood clots and to lower the chance of new clots forming in the body. It works by blocking the effects of vitamin K, reducing the blood's ability to clot. Regular blood tests are needed to monitor how the medicine is working.

What is Coumadin Tablet

Coumadin is a prescription anticoagulant, often called a blood thinner. It contains warfarin sodium and is used to treat blood clots and lower the chance of new clots forming in your body.

Coumadin Tablet uses

• Treats blood clots in veins or arteries
• Prevents blood clots from forming in the body, which lowers the risk of stroke, heart attack, or other serious conditions
• Prevention and treatment of venous thrombosis and its extension, and pulmonary embolism
• Prevention and treatment of clot-related complications from atrial fibrillation and/or cardiac valve replacement
• Reduces the risk of death, repeat heart attack, and clot-related events such as stroke after a heart attack
• Used for conditions such as atrial fibrillation, deep vein thrombosis, pulmonary embolism, or mechanical heart valves

Benefits of Coumadin Tablet

• Reduces the risk of stroke, heart attack, or other serious conditions caused by blood clots
• Significantly reduces the risk of clot-related stroke in people with atrial fibrillation

How Coumadin Tablet works

Warfarin works by blocking the effects of vitamin K, which the body needs to make certain clotting factors. This reduces the blood's ability to form clots.

Coumadin Tablet dosage

Take exactly as prescribed by your doctor; do not take more or less than directed or for longer than directed. Take at about the same time every day. It can be taken with or without food. Swallow tablets whole with a glass of water; do not crush or chew them. Never take a double dose to make up for a missed one. If you miss a dose, take it as soon as possible the same day, then continue your normal schedule the next day.

You will need regular blood tests (INR tests) to check how the medicine is working and to adjust your dose. Do not switch between different brands of warfarin without talking to your doctor. Tell your doctor if you are sick with diarrhea, fever, chills, or flu symptoms, or if your body weight changes. Wear or carry identification stating that you take this medicine. Tell any doctor, dentist, or pharmacist that you are taking this medicine, especially before surgery or dental work. Pregnant women should not handle crushed or broken tablets.

Available forms and strengths

• Tablets (1 mg, 2 mg, 2.5 mg, 3 mg, 4 mg, 5 mg, 6 mg, 7.5 mg, 10 mg)
• Injection (for intravenous use)

Side effects of Coumadin Tablet

Common

• Bruising
• Nosebleeds
• Bleeding gums after brushing
• Increased or heavier menstrual bleeding
• Prolonged bleeding from cuts
• Swollen ankles
• Painful swelling or discomfort
• Stomach pain
• Joint pain
• Persistent headache or fever
• Nausea, vomiting, diarrhea
• Taste changes
• Abdominal pain, bloating, gas
• Rash, itching, hair loss

Serious

• Severe or life-threatening bleeding that will not stop
• Blood in urine (pink, brown, red, or dark urine)
• Red or black, tarry stools
• Coughing up blood or vomiting blood or material that looks like coffee grounds
• Sudden headache, severe weakness, or dizziness
• Death of skin tissue (skin necrosis or gangrene)
• Purple toes syndrome (purple or dark-colored, painful toes)
• Kidney injury or problems, including blood in urine
• Chest pain, difficulty breathing or swallowing
• Signs of a serious allergic reaction: hives, difficulty breathing, swelling of face, lips, tongue, or throat
• Calciphylaxis, a serious and sometimes fatal condition
• A serious fall or head injury

Warnings and precautions

This medicine can cause serious or fatal bleeding because it is a blood thinner that lowers the chance of blood clots forming in the body. Your risk of bleeding is higher if you are 65 or older, have a history of stomach or intestinal bleeding, high blood pressure, a history of stroke or mini-stroke, serious heart disease, low blood count or cancer, recent trauma or surgery, kidney problems, or take other medicines that increase bleeding risk.

Do not take this medicine if your risk of bleeding problems outweighs the possible benefit, if you are pregnant (unless you have a mechanical heart valve), or if you are allergic to warfarin or any of its ingredients.

Death of skin tissue (necrosis or gangrene) is a rare but serious risk that can happen soon after starting this medicine, due to blood clots blocking blood flow to an area of the body. This medicine may cause clots that block normal blood flow, potentially leading to tissue death or amputation of the affected body part.

Avoid activities or sports that could cause a serious injury, since this medicine increases your risk of bleeding. Many other medicines, including over-the-counter drugs and herbal products, can affect your INR and increase bleeding risk. Do not start or stop any medicine without talking to your doctor first. Avoid making changes to your diet without talking to your doctor first, since foods high in vitamin K can make this medicine less effective.

Do not take this medicine if you are pregnant, unless you have a mechanical heart valve, because it can cause birth defects, miscarriage, or death of an unborn baby. A pregnancy test is done before starting treatment, and effective birth control should be used during treatment and for at least one month after the last dose.

It is not fully known whether warfarin passes into breast milk in meaningful amounts. If you breastfeed while taking this medicine, watch your baby for signs of bruising or bleeding, and talk to your doctor about the decision.

Tell your doctor if you have kidney disease or are on dialysis, since this medicine can sometimes cause kidney injury, and your doctor may test you more often if you already have kidney problems. Tell your doctor if you have liver problems, as liver impairment can increase the effect of this medicine and requires caution.

Avoid drinking alcohol while taking this medicine, and tell your doctor if you drink alcohol. Be careful before you drive or use machines or tools until you know how this medicine affects you, since it may cause dizziness in some people.

Storage

• Store at room temperature between 68°F to 77°F (20°C to 25°C)
• Keep in a tightly closed container
• Keep out of the light and moisture
• Do not store in the bathroom or near a sink, or in the car or on window sills
• Keep out of reach of children
• Follow your healthcare provider or pharmacist's instructions about how to properly throw away outdated or unused medicine
• Females who are pregnant should not handle crushed or broken tablets

When to see a doctor

Get emergency help right away for any bleeding that will not stop. Call your doctor right away if you notice signs of bleeding such as pain, swelling, or discomfort; headaches, dizziness, or weakness; unusual bruising; nosebleeds; bleeding gums; cuts that take a long time to stop bleeding; heavier than normal menstrual or vaginal bleeding; pink or brown urine; red or black stools; coughing up blood; or vomiting blood or material that looks like coffee grounds.

Call your healthcare provider right away if you take too much medicine, are sick with diarrhea, an infection, or fever, or if you fall or injure yourself, especially if you hit your head. Call your healthcare provider right away if you notice pain, a color change, or a temperature change to any area of your body, as this could mean tissue damage and you may need urgent medical care to prevent amputation.

Call your healthcare provider right away if you have pain in your toes and they look purple or dark in color (purple toes syndrome). Tell your doctor right away if you develop blood in your urine, since this could be a sign of kidney injury.

Get emergency medical help or contact your local poison control center right away if you think you have taken too much of this medicine, since an overdose can cause excessive bleeding. Seek emergency medical help for signs of an allergic reaction such as hives, difficulty breathing, or swelling of the face, lips, tongue, or throat. Tell your doctor immediately if you become pregnant while taking this medicine.

Alternatives

• Jantoven
• Marevan
• Fluindione (Previscan)
• Acenocoumarol (Sintrom, Mini-Sintrom)