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Coumadin - (Warfarin Sodium) is prescribed
for the prophylaxis and/or treatment of venous thrombosis
and its extension, and pulmonary embolism. It is also indicated
for the prophylaxis and/or treatment of the thromboembolic
complications associated with atrial fibrillation and/or
cardiac valve replacement, reducing the risk of death, recurrent
myocardial infarction, and thromboembolic events such as
stroke or systemic embolization after myocardial infarction.
The dosage and administration of Coumadin
- Warfarin must be individualized for each patient according
to the particular patient's PT/INR response to the drug
and his / her condition. The starting dose is usually 2
to 5 milligrams (mg) per day for two to four days which
may later be adjusted depending on the condition and blood
test results.
While taking Coumadin - Warfarin,
it is very important to avoid sports and activities that
may cause injury. Any falls, blows to the body or head or
other injuries should be reported to the doctor immediately
since serious internal bleeding may occur without the patient
becoming aware of it. Patients should also be careful to
avoid cutting themselves. This includes special care to
be taken in brushing teeth and shaving. It is better to
use a soft brush and floss gently as well as to use an electric
shave and avoid a blade. Drinking too much alcohol may change
the way this anticoagulant affects the body. It is advisable
to avoid drinking on a daily basis and also take no more
than one or two drinks at any time.
Like all other medicines, Coumadin
- Warfarin also has its side effects which include hypersensitivity/allergic
reactions, systemic cholesterol microembolization, purple
toes syndrome, hepatitis, cholestatic hepatic injury, jaundice,
elevated liver enzymes, vasculitis, edema, fever, rash,
dermatitis including bulbous eruptions, urticaria, abdominal
pain including cramping, flatulence/bloating, fatigue, lethargy,
malaise, asthenia, nausea, vomiting, diarrhea, pain, headache,
dizziness, taste perversion, pruritus, alopecia, cold intolerance,
and paresthesia including feeling cold and chills. Any bleeding
while the PT/INR is within therapeutic range should be diagnostically
investigated since it could mean a previously unsuspected
lesion like a tumor or ulcer. The anticoagulant effect of
the medication may also cause fatal or nonfatal hemorrhage
from any tissue or organ. The possibility of hemorrhage
should be always considered in evaluating the condition
of any anticoagulated patient with complaints which do not
indicate an obvious diagnosis.
Bleeding during anticoagulant therapy does
not always correlate with PT/INR. After the medicine is
stopped, the body needs time to recover before it can return
to its normal blood clotting ability. It is necessary that
the same care be taken during this period as during the
treatment in order to ensure that no unexpected complications
occur.
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