Warfin (5mg) 100 Tablets

Warfarin works by inhibiting the enzyme vitamin K epoxide reductase. This enzyme is crucial for converting vitamin K into its active form in the liver. Active vitamin K is necessary for the synthesis of certain clotting factors, specifically factors II (prothrombin), VII, IX, and X, as well as proteins C and S, which are involved in blood clotting. By blocking the activation of vitamin K, warfarin decreases the production of these clotting factors. As a result, the blood's ability to clot is reduced, which helps prevent the formation of harmful blood clots in veins, arteries, or the heart.

Warfarin dosage recommendations are:

• Prophylaxis of pulmonary embolism - 5-10 mg daily for 1 or 2 days - Maintenance 3-9 mg daily
• Prophylaxis of systemic embolism in patients with atrial fibrillation - 5-10 mg daily for 1 or 2 days - Maintenance 3-9 mg daily
• Prophylaxis of systemic embolism in patients with rheumatic heart disease - 5-10 mg daily for 1 or 2 days - Maintenance 3-9 mg daily
• Prophylaxis of thromboembolism following cardiac valve replacement - 5-10 mg daily for 1 or 2 days - Maintenance 3-9 mg daily
• Prophylaxis of venous thrombosis - 5-10 mg daily for 1 or 2 days - Maintenance 3-9 mg daily
• Pulmonary embolism - 5-10 mg daily for 1 or 2 days - Maintenance 3-9 mg daily
• Transient ischaemic attack - 5-10 mg daily for 1 or 2 days - Maintenance 3-9 mg daily
• Venous thrombosis - 5-10 mg daily for 1 or 2 days - Maintenance 3-9 mg daily

In the case of abnormal bleeding due to warfarin overdose, which may present as hematuria, blood in stools, melena, petechiae, excessive menstrual bleeding, excessive bruising, or persistent oozing from superficial injuries, the management involves several steps. First, discontinue warfarin immediately. If the patient presents within 1 hour of ingesting 0.25 mg/kg or more than their therapeutic dose, activated charcoal may be administered. Oral vitamin K1 (phytomenadione) should be given in doses of 10-20 mg (or 250 mcg/kg for children), but it should be delayed at least 4 hours after activated charcoal administration. Repeat the INR after 24 hours and consider further doses of vitamin K1 if necessary. In life-threatening cases, administer prothrombin complex concentrate (factors II, VII, IX, and X) at 30-50 units/kg or fresh-frozen plasma at 15 mL/kg if the concentrate is unavailable. For non-life-threatening cases, phytomenadione can be given via slow IV injection. If rapid re-anticoagulation is needed, such as in valve replacements, use prothrombin complex concentrate or fresh-frozen plasma. Monitor INR for at least 48 hours following the overdose and assess when to resume normal therapy.

If you miss a dose of Warfarin, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double up on doses.

Administer the medication orally with a full glass of water, and you may take it with or without food. It’s important to maintain a consistent routine, taking Warfarin at the same time each day to help remember.

Warfarin tablets should not be taken in the following situations:

• Allergy to warfarin sodium or any other ingredients listed
• History of a stroke due to bleeding from a blood vessel in the brain
• Pregnancy, planning to become pregnant, or having had a baby in the last 48 hours
• Surgery in the last 72 hours
• Use of medicines that may increase bleeding risk or other anticoagulants
• Unusual bruising or bleeding
• Physical conditions with a risk of bleeding, such as a recent stroke

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Drug interactions with warfarin include:

• Antiplatelet agents (e.g., clopidogrel, aspirin) (may increase bleeding risk)
• NSAIDs (e.g., ibuprofen, naproxen) (may increase bleeding risk)
• Antibiotics (e.g., ciprofloxacin, metronidazole) (may increase warfarin levels by affecting gut flora or liver metabolism)
• CYP2C19 inducers (e.g., rifampin) (may decrease warfarin levels)
• CYP2C19 inhibitors (e.g., omeprazole) (may increase warfarin levels)
• Vitamin K (e.g., in supplements or dietary changes) (may decrease warfarin effectiveness)
• Herbal supplements (e.g., St. John’s wort, ginkgo biloba) (may interact with warfarin, affecting its levels and efficacy)

Store in a cool, dry place. Avoid exposure to light. Dispose of unused or expired medication at a pharmacy take-back program.