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Back to Drug index
Warfarin sodium
Coumadin, Panwarfin, Sofarin
Pregnancy Category D
Drug classes
Coumarin derivative
Anticoagulant
Mechanism of action
Interferes with the hepatic synthesis of vitamin K-dependent clotting
factors (factors II-prothrombin, VII, IX, and X), resulting in their eventual
depletion and prolongation of clotting times.
Indications
- Venous thrombosis and its extension, treatment, and prophylaxis
- Treatment of atrial fibrillation with embolization
- Pulmonary embolism, treatment, and prophylaxis
- Prophylaxis of systemic emobization after acute MI
Unlabeld uses:
- Prevention of recurrent transient ischemic attacks
- Prevention of recurrent myocardial infarction
- Adjunct to therapy in small-cell carcinoma of the lung
Contraindications
- Allergy to warfarin or tartrazine (contained in the 7.5-mg tablet
marketed as Panwarfin);
- SBE
- Hemorrhagic disorders
- Tuberculosis
- Hepatic diseases
- GI ulcers
- Renal disease
- Indwelling catheters
- Spinal puncture
- Aneurysm
- Diabetes
- Visceral carcinoma
- Uncontrolled hypertension
- Severe trauma (including recent or contemplated CNS, eye surgery;
recent placement of IUD)
- Threatened abortion
- Menometrorrhagia
- Pregnancy (known to cause fetal damage and death)
- Lactation (suggest using heparin if anticoagulation is required)
Use caution in the presence of CHF,
diarrhea, fever; thyrotoxicosis;
senile, psychotic, or depressed patients.
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Adverse effects
- GI: Nausea, vomiting, anorexia,
abdominal cramping,
diarrhea, retroperitoneal hematoma, hepatitis, jaundice, mouth
ulcers
- Hematologic: Granulocytosis, leukopenia,
eosinophilia
- GU: Priapism, nephropathy, red-orange
urine
- Dermatologic: Alopecia, urticaria,
dermatitis
- Bleeding: Hemorrhage; GI or urinary
tract bleeding (hematuria, dark stools; paralytic ileus, intestinal obstruction
from hemorrhage into GI tract); petechiae and purpura, bleeding from mucous
membranes; hemorrhagic infarction, vasculitis, skin necrosis of female
breast; adrenal hemorrhage and resultant adrenal insufficiency; compressive
neuropathy secondary to hemorrhage near a nerve
- Other: Fever, "purple toes" syndrome
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