Coumadin

Patients & Caregivers

Whether you’re helping out a friend or a family member, there are a few important things you should know about the patient’s COUMADIN® (Warfarin Sodium) therapy.

COUMADIN is an anticoagulant. Anti means against, and coagulant refers to blood clotting. An anticoagulant helps reduce clots from forming in the blood.

The patient’s PT/INR must be measured regularly

It is important that patients have their blood tested regularly with a test known as an INR (International Normalized Ratio), sometimes referred to as a PT (Protime) test. The PT/INR allows the doctor to monitor the therapeutic effect of COUMADIN and make dosage adjustments as needed.

Report any problems

If any of the following occur, call the patient’s doctor or nurse immediately:

  • Patient becomes pregnant or plans to become pregnant
  • Fever or illness, including vomiting, diarrhea, or infection
  • Pain, swelling, discomfort, or any other unusual symptoms
  • Prolonged bleeding from cuts or nosebleeds
  • Unusual bleeding from gums when brushing teeth
  • Increased menstrual flow or vaginal bleeding
  • Red or dark brown urine
  • Red or black stools
  • Unusual bruising for unknown reasons
  • Do not allow patient to start, discontinue or change other medicine without doctor’s advice.
  • Always tell other doctors, dentists, pharmacists, or nurses that the patient is on COUMADIN (Warfarin Sodium).
  • Patient should keep the same general diet from day to day.
  • Patient should avoid alcohol.
  • If patient forgets to take a tablet, let the doctor know immediately. The patient should take the missed dose as soon as possible on the same day, but should NOT take a double dose of COUMADIN the next day.
  • Be aware that COUMADIN and all generic warfarin tablets represent the same medication and should not be taken together as overdosage may result.

Reducing the risk of falling within the home

IMPORTANT: If the patient falls, call the patient’s healthcare provider, because the patient may need to come in for an examination.

Improve lighting

  • Make sure all living areas are well lit with light switches at every entrance.
  • Install night-lights along walkway from bedroom to bathroom.
  • Make sure stairways and steps are well lit.

Improve footing

  • Attach or secure handrails near all steps, toilets, and tubs or showers.
  • Use only rubber-backed bathroom mats.
  • Attach shower stool or no-skid strips to bottom of tub (instead of
    suction-cup tub mats).
  • Attach all throw rugs to floor (adhesive, nails, etc.).
  • Carpet over any uneven junction between rooms.

Improve walkways between rooms

  • Keep common walking paths clear of furniture, plants, and electrical
    or telephone cords.
  • Clean up all spills and pick up shoes, clothes, or any other objects that could be tripped over.
  • Take extra precautions outdoors on wet or icy surfaces.
  • Consider using a cane for extra stability.

INDICATIONS:

  • COUMADIN® (Warfarin Sodium) is used to help prevent and treat blood clots in the legs, lungs, and those clots associated with heart-valve replacement or an irregular, rapid heartbeat called atrial fibrillation.
  • If you have had a heart attack, COUMADIN may be used to lower the risk of death, another heart attack, stroke, and blood clots moving to other parts of the body.

IMPORTANT SAFETY INFORMATION:

  • COUMADIN can cause serious and life-threatening bleeding. Bleeding is more likely to occur when you first start taking COUMADIN and with a higher dose.
  • Factors that can increase your risk of bleeding while on COUMADIN therapy include being 65 years of age or older, an INR greater than 4, highly variable INRs, history of bleeding involving the stomach or intestine, high blood pressure, certain diseases of the brain, heart or kidney, anemia, cancer, physical injury, taking other drugs, and a long duration of therapy.
  • The PT/INR test checks to see how fast your blood clots. Your healthcare provider will decide what PT/INR numbers are best for you. Your dose of COUMADIN will be adjusted to keep your PT/INR in a target range for you.
  • Tell your healthcare provider right away if you have any signs or symptoms of bleeding problems such as the following: pain, swelling or discomfort, headache, dizziness, or weakness, unusual bruising, nosebleeds, bleeding of gums, bleeding from cuts that take a long time to stop, menstrual flow or vaginal bleeding that is heavier than normal, pink or brown urine, red or black stools, coughing up blood, or vomiting blood or material that looks like coffee grinds.

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  • Do not take COUMADIN (Warfarin Sodium) if you are pregnant or plan to become pregnant. COUMADIN can cause death or birth defects to an unborn baby. Use effective birth control if you can get pregnant.
  • Speak to your healthcare provider before breast-feeding while taking COUMADIN.
  • Tell your healthcare provider about all the medical conditions you may have, including recent or planned surgeries or medical or dental procedures.
  • Unsupervised patients with declining mental function due to aging or mental illness, and patients with alcoholism or increased risk of bleeding should not take COUMADIN.
  • Death of skin tissue (skin necrosis or gangrene) is a serious, side effect of COUMADIN. It happens because blood clots form and block blood flow to an area of your body. Call your healthcare provider right away if you have pain, color, or temperature change to any area of your body. You may need medical care right away to prevent death or loss (amputation) of your affected body part.
  • Call your healthcare provider right away if you have pain in your toes and they look purple or dark in color. You may be experiencing a serious condition known as purple toes syndrome.
  • Many factors alone or together such as changes in diet and medicines, including herbal supplements, may affect your response to COUMADIN. Tell your healthcare provider about your diet, all prescription and non-prescription medicines, vitamins, and herbal products you are taking or plan to take. Speak with your healthcare provider before starting, changing, or stopping any of these products. Many drugs, including aspirin and other pain medicines, may interact with COUMADIN (Warfarin Sodium).
  • Eat a normal balanced diet. Do not make changes in your diet, such as eating large amounts of leafy green vegetables, which contain Vitamin K without first talking to your healthcare provider.
  • Avoid alcohol consumption, cranberry juice, and cranberry products while taking COUMADIN.
  • Tell your doctor if you have any illness such as diarrhea, infection or fever.
  • Be aware that COUMADIN and generic warfarin tablets represent the same medication and should not be taken together, as overdosage may result.
  • If you take too much or miss a dose of COUMADIN, call your healthcare provider. Take the missed dose as soon as possible on the same day. Do not take a double dose of COUMADIN the next day to make up for a missed dose.
  • If you have any other questions about COUMADIN (Warfarin Sodium) and your condition, contact your healthcare provider.
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COUMADIN® is a registered trademark of Bristol-Myers Squibb Pharma Company.

COUMADIN (Warfarin Sodium), the COUMADIN color logo, COLORS OF COUMADIN, and the color and configuration of COUMADIN tablets are trademarks of Bristol-Myers Squibb Pharma Company.