– 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.
-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.
-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.
-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.