Warfarin
WARFARIN- anticoagulant IND - to prevent the formation of new blood clots and prevent existing blood clots from getting larger. -Mode of action of warfarin: Interferes with the synthesis of vitamin K-dependent clotting factors. HOW TO USE? -The strength and colour of the tablet 1 mg - Apo-Warfarin (brown), Coumadin (pink) 2 mg - Apo-Warfarin (lavender), Coumadin (purple) 3 mg - Orfarin (blue). 5 mg - Apo-Warfarin (peach), Coumadin (peach), Orfarin (pink). -Remind the patient not to remember the colour, remember the dose prescribed instead. The dosage and administration -Dose & duration based on indication and international normalised ratio (INR) target. -Must be taken at the same time every day. -If missed a dose for more than 8 hours, skip the dose and take the next dose (do not double the dose). -To inform healthcare professionals (dentist, surgeon, doctor, pharmacist) if patient is planning to get pregnant, tooth extraction, or when getting consultation for medication, supplement or herbal remedies. INR -To check how long it takes for your blood to clot. The higher your INR is, the longer it takes for your blood to clot. Target INR -The targeted INR is 2-3 except for stroke prophylaxis in patients with mechanical heart valves such as mitral valves (INR of 2.5-3.5). -Follow the scheduled blood test and the counselling appointment made to achieve targeted INR as suggested by the doctor. -Bring along anticoagulant booklet and all medications during the doctor/pharmacist appointment. Side effects of medication -Educate patient on symptoms of bleeding such as bruises of unknown cause, blood in urine/dark-coloured urine, black stools,gum bleeding or heavy menstrual bleeding. -Report to doctor and pharmacist if any sign or symptom of bleeding occurs. Drug-drug/food interactions -Consult doctor and pharmacist before starting, stopping or changing dose of any medication/supplement, irregardless ofwhether it is a prescription or over-the-counter medication including traditional medicines. -Monitor the intake of food which are rich in vitamin K such as green, leafy vegetables. Have consistent intake of vegetables and food with high content of high vitamin K. -Follow a balanced and consistent diet. -Review patient’s lifestyle such as alcohol consumption, smoking and stress. Advice to only consume small quantity of alcohol, -stop smoking and manage stress as these will affect the therapy. Pregnancy and breastfeeding -Advise women with childbearing age that warfarin can have adverse effects on fetal development (first trimester), therefore,need to inform doctor if planning to get pregnant. -Very little warfarin gets into the breast milk, therefore, it is safe to be taken if the mother is breastfeeding. Thank You.
