Country of origin: Denmark
Pharm-Group: Indirect-acting anticoagulants
Manufacturers: Nycomed Pharma AS (Denmark)
International name: Warfarin
Synonyms: Warfarex
Dosage forms: tablets 2.5 mg
Composition: Active substance - Warfarin.
Indications for use: Prevention of thrombosis and thromboembolism. Short-term - for acute venous thrombosis and pulmonary embolism (in combination with heparin), postoperative thrombosis, acute myocardial infarction, surgical and thrombolytic treatment of thrombosis, cardioversion in case of atrial flutter. Long-term - for recurrent vein thrombosis and pulmonary embolism, prosthetic heart valves and blood vessels (possibly in combination with acetylsalicylic acid), coronary artery disease, transient attacks of ischemia, secondary prevention of heart attack, chronic atrial fibrillation, peripheral arterial thrombosis.
Contraindications: Acute bleeding, severe dysfunction of the liver and kidneys, severe arterial hypertension, pregnancy. For safety reasons, breastfeeding should be suspended during the first 3 days of treatment.
Side effects: Hemorrhages, vasculitis, diarrhea, increased activity of liver enzymes, eczema, skin necrosis, hair loss.
Interaction: The anticoagulant effect is enhanced by acetylsalicylic acid and other NSAIDs, allopurinol, amiodarone, anabolic agents (with alkyl in the C17 position), oral hypoglycemic sulfonamide agents, cephalosporins, cimetidine, danazol, diazoxide, disopyramide, disulfiram, erythromycin, ethacrynic acid, fluconazole, fluorine uracil , levamisole, dipiradamole, chloramphenicol, fluvoxamine, glucagon, heparin, isoniazid, ketoconazole, quinine, quinidine, quinolones, clarithromycin, clofibrate, chloral hydrate, chloramphenicol, metronidazole, miconazole, nalidixic acid, nilutamide, omeprazole, paroxetine, proguanil, simvastatin, sulfonamides, tamoxifen, thyroxine; weaken - oral laxatives, barbiturates, dicloxacillin, phenazone, griseofulvin, carbamazepine, coenzyme Q10, cholestyramine, mianserin, paracetamol (in high doses), retinoids, rifampicin, sucralfate, phenytoin, vitamin K (antagonist).
Overdose: Symptoms - increased bleeding, bleeding. Treatment: in case of significant bleeding - slow intravenous administration of small doses of phytomenadione, possible blood transfusion.
Special instructions: At the beginning of treatment and every 4-8 weeks, blood clotting should be monitored using the INR. When combined with other drugs, continuous monitoring is required. Particular care should be taken in patients with endogenous bleeding disorders, thrombocytopenia, severe hypertension, gastric and duodenal ulcers in the acute stage, impaired liver and kidney function, cerebral hemorrhages, and alcoholism. Alcohol consumption increases the risk of hypoprothrombinemia and bleeding.
Literature: Encyclopedia of Medicines 2002.