Medications and COUMADIN® (warfarin sodium)

Many medicines and herbal products can interact with COUMADIN and affect the dose you need or increase COUMADIN side effects. Do not change or stop any of your medicines, or start any new medicines, before you talk to your doctor.

Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Some of your other medicines may affect the way COUMADIN works. Certain medicines may increase your risk of bleeding.

It is important to know the medicines you take. Use our tool to keep a list of the medicines you take and bring it to your doctor.

Medications

Some medications, both prescription and over-the-counter, increase the blood thinning effect of COUMADIN, while others decrease the effect. An increase in the effect could put you at risk for bleeding, while a decrease could put you at risk for forming clots.

A few examples of medications that increase your risk of bleeding include:

Since these examples are not all-inclusive, it is important to tell your doctor about all of the drugs you are taking.

Herbal Products

Herbal products can also interact with COUMADIN. An increase in the effect of COUMADIN could put you at risk for bleeding, while a decrease could put you at risk for forming clots.

Some herbal products that increase the effects of COUMADIN are garlic and ginkgo supplements. Herbal products that decrease the effect of COUMADIN include St. John’s wort, co-enzyme Q10, and ginseng.* Again, these examples are not an all-inclusive list of herbal products that may affect your COUMADIN therapy, so tell your doctor about all herbal products you are taking.

*Talk to your doctor about taking other medicines and herbal products with COUMADIN because they can affect your INRThe INR is a test of blood clotting. It is primarily used to monitor warfarin therapy, where the aim is to maintain an INR in a target range. results. You can use the My Meds tool to record the medications and herbal products you currently take to help you have this discussion with your doctor.

IMPORTANT SAFETY INFORMATION

What is the most important information I should know about COUMADIN® (warfarin)?

COUMADIN can cause bleeding which can be serious and sometimes lead to death. This is because COUMADIN is a blood thinner medicine that lowers the chance of blood clots forming in your body.

  • You may have a higher risk of bleeding if you take COUMADIN and:

    • are 65 years of age or older
    • have a history of stomach or intestinal bleeding
    • have high blood pressure (hypertension)
    • have a history of stroke, or “mini-stroke” (transient ischemic attack or TIA)
    • have serious heart disease
    • have a low blood count or cancer
    • have had trauma, such as an accident or surgery
    • have kidney problems
    • take other medicines that increase your risk of bleeding, including:
      • a medicine that contains heparin
      • other medicines to prevent or treat blood clots
      • nonsteroidal anti-inflammatory drugs (NSAIDs)
    • take warfarin sodium for a long time. Warfarin sodium is the active ingredient
      in COUMADIN

Tell your healthcare provider if you take any of these medicines. Ask your healthcare provider if you are not sure if your medicine is one mentioned above. Many other medicines can interact with COUMADIN, and affect the dose you need or increase COUMADIN side effects. Do not change or stop any medicines, or start new ones, before talking to your healthcare provider.

  • Get your regular blood test (INR test) to check for your response to COUMADIN, to see how fast your blood clots. Your healthcare provider will decide what INR numbers are best for you and adjust your dose of COUMADIN to keep your INR in your target range.
  • Call your healthcare provider right away if you get any of the following signs or symptoms of bleeding problems:

    • pain, swelling, or discomfort
    • headaches, dizziness, or weakness
    • unusual bruising (bruises that develop without known cause or grow in size)
    • nosebleeds
    • bleeding gums
    • bleeding from cuts takes a long time to stop
    • menstrual bleeding or vaginal bleeding that is heavier than normal
    • pink or brown urine
    • red or black stools
    • coughing up blood
    • vomiting blood or material that looks like coffee grounds
  • Some foods and beverages can interact with COUMADIN and affect your treatment and dose.

    • Eat a normal balanced diet and talk to your healthcare provider before making any diet changes. Do not eat large amounts of leafy green vegetables, which contain vitamin K. Certain vegetable oils also contain large amounts of vitamin K. Too much vitamin K can lower the effect of COUMADIN.

Do not take COUMADIN if:

  • your chance of having bleeding problems is higher than the possible benefit of treatment; your healthcare provider will decide if COUMADIN is right for you.
  • you are pregnant unless you have a mechanical heart valve. COUMADIN may cause birth defects, miscarriage, or death of your unborn baby.
  • you are allergic to warfarin or any of the other ingredients in COUMADIN.
  • you are taking other medicines that contain warfarin sodium.

Before you take COUMADIN, tell your healthcare provider if you:

  • have bleeding problems, fall often, have liver or kidney problems, have high blood pressure, have a heart problem called congestive heart failure, have diabetes, have any other medical conditions.
  • are planning to have any surgery or dental procedure; your COUMADIN may need to be stopped for a short time, or your dose adjusted.
  • are pregnant or plan to become pregnant or are considering breastfeeding while taking COUMADIN.
  • Tell your healthcare providers that you take COUMADIN, and about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Some medicines may affect how COUMADIN works, or may increase your risk of bleeding. Keep a list of medicines to show your healthcare provider and pharmacist.

COUMADIN may cause serious side effects including:

  • Death of skin tissue (skin necrosis or gangrene). This can happen soon after starting COUMADIN, and 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 changes to any area of your body. You may need medical care right away to prevent death or loss (amputation) of your affected body part.
  • “Purple toes syndrome.” Call your healthcare provider right away if you have pain in your toes and they look purple or dark in color.
  • These are not all the side effects of COUMADIN; tell your healthcare provider if you have any side effect that bothers you or does not go away.

What is COUMADIN? Coumadin is a prescription medicine used to treat blood clots and to lower the chance of blood clots forming in your body. Blood clots can cause a stroke, heart attack, or other serious conditions if they form in the legs or lungs.

INDICATIONS

  • COUMADIN 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.

Please see Important Safety Information and U.S. Full Prescribing Information including Boxed WARNING regarding bleeding risk and Medication Guide for COUMADIN®.

Medications and Coumadin

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.

My Medication Tools

My Meds
Coumadin Reminder

Download this file to your computer
to print and complete.

Download the COUMADIN full Prescribing Information including Boxed WARNING regarding bleeding risk
and Medication Guide.

Download this file to your computer to print and complete.

Download the COUMADIN full Prescribing Information including Boxed WARNING regarding bleeding risk and Medication Guide.

Download this file to your computer to print and complete.

Download the COUMADIN full Prescribing Information including Boxed WARNING regarding bleeding risk and Medication Guide.

IMPORTANT SAFETY INFORMATION

What is the most important information I should know about COUMADIN® (warfarin)?

COUMADIN can cause bleeding which can be serious and sometimes lead to death. This is because COUMADIN is a blood thinner medicine that lowers the chance of blood clots forming in your body.

  • You may have a higher risk of bleeding if you take COUMADIN and:

    • are 65 years of age or older
    • have a history of stomach or intestinal bleeding
    • have high blood pressure (hypertension)
    • have a history of stroke, or “mini-stroke” (transient ischemic attack or TIA)
    • have serious heart disease
    • have a low blood count or cancer
    • have had trauma, such as an accident or surgery
    • have kidney problems
    • take other medicines that increase your risk of bleeding, including:
      • a medicine that contains heparin
      • other medicines to prevent or treat blood clots
      • nonsteroidal anti-inflammatory drugs (NSAIDs)
    • take warfarin sodium for a long time. Warfarin sodium is the active ingredient
      in COUMADIN

Tell your healthcare provider if you take any of these medicines. Ask your healthcare provider if you are not sure if your medicine is one mentioned above. Many other medicines can interact with COUMADIN, and affect the dose you need or increase COUMADIN side effects. Do not change or stop any medicines, or start new ones, before talking to your healthcare provider.

  • Get your regular blood test (INR test) to check for your response to COUMADIN, to see how fast your blood clots. Your healthcare provider will decide what INR numbers are best for you and adjust your dose of COUMADIN to keep your INR in your target range.
  • Call your healthcare provider right away if you get any of the following signs or symptoms of bleeding problems:

    • pain, swelling, or discomfort
    • headaches, dizziness, or weakness
    • unusual bruising (bruises that develop without known cause or grow in size)
    • nosebleeds
    • bleeding gums
    • bleeding from cuts takes a long time to stop
    • menstrual bleeding or vaginal bleeding that is heavier than normal
    • pink or brown urine
    • red or black stools
    • coughing up blood
    • vomiting blood or material that looks like coffee grounds
  • Some foods and beverages can interact with COUMADIN and affect your treatment and dose.

    • Eat a normal balanced diet and talk to your healthcare provider before making any diet changes. Do not eat large amounts of leafy green vegetables, which contain vitamin K. Certain vegetable oils also contain large amounts of vitamin K. Too much vitamin K can lower the effect of COUMADIN.

Do not take COUMADIN if:

  • your chance of having bleeding problems is higher than the possible benefit of treatment; your healthcare provider will decide if COUMADIN is right for you.
  • you are pregnant unless you have a mechanical heart valve. COUMADIN may cause birth defects, miscarriage, or death of your unborn baby.
  • you are allergic to warfarin or any of the other ingredients in COUMADIN.
  • you are taking other medicines that contain warfarin sodium.

Before you take COUMADIN, tell your healthcare provider if you:

  • have bleeding problems, fall often, have liver or kidney problems, have high blood pressure, have a heart problem called congestive heart failure, have diabetes, have any other medical conditions.
  • are planning to have any surgery or dental procedure; your COUMADIN may need to be stopped for a short time, or your dose adjusted.
  • are pregnant or plan to become pregnant or are considering breastfeeding while taking COUMADIN.
  • Tell your healthcare providers that you take COUMADIN, and about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Some medicines may affect how COUMADIN works, or may increase your risk of bleeding. Keep a list of medicines to show your healthcare provider and pharmacist.

COUMADIN may cause serious side effects including:

  • Death of skin tissue (skin necrosis or gangrene). This can happen soon after starting COUMADIN, and 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 changes to any area of your body. You may need medical care right away to prevent death or loss (amputation) of your affected body part.
  • “Purple toes syndrome.” Call your healthcare provider right away if you have pain in your toes and they look purple or dark in color.
  • These are not all the side effects of COUMADIN; tell your healthcare provider if you have any side effect that bothers you or does not go away.

What is COUMADIN? Coumadin is a prescription medicine used to treat blood clots and to lower the chance of blood clots forming in your body. Blood clots can cause a stroke, heart attack, or other serious conditions if they form in the legs or lungs.

INDICATIONS

  • COUMADIN 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.

Please see Important Safety Information and U.S. Full Prescribing Information including Boxed WARNING regarding bleeding risk and Medication Guide for COUMADIN®.