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Warin 2
Incepta Pharmaceuticals Ltd.
Generic: Warfarin Sodium
Safety Advices
বাংলা
English
UNSAFE
It is unsafe to consume alcohol with Warin 2.
UNSAFE
Warin 2 is highly unsafe to use during pregnancy. Seek your doctor's advice as studies on pregnant women and animals have shown significant harmful effects to the developing baby.
SAFE IF PRESCRIBED
Warin 2 is safe to use during breastfeeding. Human studies suggest that the drug does not pass into the breastmilk in a significant amount and is not harmful to the baby.
SAFE
Warin 2 does not usually affect your ability to drive.
SAFE IF PRESCRIBED
Warin 2 is safe to use in patients with kidney disease. No dose adjustment of Warin 2 is recommended.
However, talk to your doctor if you have any underlying kidney disease. Regular blood tests are recommended when you are taking this medicine.
CAUTION
Warin 2 should be used with caution in patients with liver disease. Dose adjustment of Warin 2 may be needed. Please consult your doctor.
Medicine Overview of Warin 2mg Tablet
Introduction
Warin 2 is an oral anticoagulant which helps prevent the formation of harmful blood clots in the legs, lungs, brain and heart. It is used for deep vein thrombosis, pulmonary embolism and stroke prevention. Warin 2 should be taken as advised by the doctor. You may take it with or without food but it is better to take it at a fixed time. This medicine should not be stopped abruptly without consulting the doctor. You should take this medicine regularly to get the most benefit, even if you feel fine. It is preventing future harm. Use of this medicine may...
... Show moreUses of Warin 2
- Deep vein thrombosis
- Pulmonary embolism
- Stroke prevention
How to use Warin 2
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Warin 2 may be taken with or without food, but it is better to take it at a fixed time.
Avoid Warin 2 with Vitamin K rich food such as spinach, collards, broccoli, spring onions, cucumber and dried basil.
How Warin 2 works
Warin 2 is an anticoagulant. It works by preventing the formation of harmful blood clots. Although it does not dissolve the existing blood clots, it prevents them from growing larger and causing blockages in the blood vessels.
What if you forget to take Warin 2?
If you miss a dose of Warin 2, skip it and continue with your normal schedule. Do not double the dose.
Quick Tips
- Avoid making sudden major changes to your diet during treatment with this medicine.
- Do not consume alcohol while taking Warin 2 as this may increase its side effects.
- If you are going to have a surgery or dental treatment, you may be asked to stop taking Warin 2 temporarily.
- Do not discontinue use without consulting your doctor as this may increase your chances of having another heart attack or stroke.
Brief Description
Indication
Venous thromboembolism, Stroke prevention, Deep vein thrombosis
Administration
May be taken with or without food.
Adult Dose
Oral
Treatment and prophylaxis of venous thromboembolism, Stroke & Thromboembolism, Post-Myocardial Infarction
Adult: Initially, 2-5 mg qDay for 2 days, OR 10 mg daily for 2 days in healthy individuals
Initiate warfarin on day 1 or 2 of LMWH or unfractionated heparin therapy and overlap until desired INR, THEN discontinue heparin
Check INR after 2 days and adjust dose according to results
Usual maintenance dose: 2-10 mg daily.
Elderly: Anticoagulation
Lower doses required to produce therapeutic level of anticoagulation
Initial: <5 mg PO qDay
Maintenance: 2-5 mg PO qDay
Hepatic impairment: Severe: Avoid.
Child Dose
Thrombosis
Prevention/treatment: If baseline INR is 1.0-1.3, administer loading dose of 0.1-0.2 mg/kg PO qDay × 1 day; check INR on days 2-4 and adjust daily dose to maintain INR between 2.0 and 3.0 (unless valve replacement indicates a higher range)
Use 0.1 mg/kg to initiate therapy with liver impairment or in patients who have had a Fontan procedure
Typical maintenance dose: 0.09-0.33 mg/kg/day, with infants <12 months old often requiring doses at high end of range
Contraindication
Patient w/ haemorrhagic tendencies or blood dyscrasias, recent or contemplated surgery of the CNS or eye, those undergoing traumatic surgery resulting in large open surfaces, overt bleeding or active ulceration involving the GI, genitourinary or resp tract, cerebrovascular haemorrhage, cerebral aneurysms, dissecting aorta, pericarditis and pericardial effusions, bacterial endocarditis, threatened abortion, eclampsia, pre-eclampsia, malignant HTN. Unsupervised patients w/ conditions associated w/ potential high level of non-compliance, spinal puncture and other diagnostic or therapeutic procedures w/ potential for uncontrolled bleeding, major regional or lumbar block anaesth. Concomitant use w/ fibrinolytic drugs (e.g. streptokinase, alteplase). Pregnancy.
Mode of Action
Warfarin inhibits synthesis of vit K-dependent coagulation factors VII, IX, X and II and anticoagulant protein C and its cofactor protein S. No effects on established thrombus but further extension of the clot can be prevented. Secondary embolic phenomena are avoided.
Precaution
Any condition where added risk of haemorrhage, necrosis and/or gangrene is present. Patient w/ heparin-induced thrombocytopenia, infectious diseases or disturbances of intestinal flora (e.g. sprue), indwelling catheters, moderate to severe HTN, vit C or K deficiency, known or suspected deficiency in protein C-mediated anticoagulant response, polycythemia vera, vasculitis, DM. Moderate to severe hepatic or renal impairment. Elderly. Lactation. Patient Counselling Eat a balanced diet w/ a constant amount of vit K. Avoid ingestion of large quantities of certain foods that contain a large amount of vit K (e.g. leafy green vegetables, certain vegetable oils), drastic changes in diet and activities...
... Show moreSide Effect
Hemorrhage is the principal adverse effect of oral anticoagulants. Jaundice, hepatic dysfunction, vasculitis, pancreatitis, nausea, vomiting, diarrhoea, taste perversion, abdominal pain, flatulence, bloating, rash, purpura, erythematous swollen skin patches leading to ecchymosis, pruritus, alopecia, purple discolouration of toes due to cholesterol embolisation, tracheal or tracheobronchial calcification, fever, chills. Unexplained drop in haematocrit, decreased Hb. Rarely, hypersensitivity reactions.
Potentially Fatal: Haemorrhage from almost any organ of the body w/ the consequent effects of haematomas as well as anaemia, tissue necrosis and/or gangrene of skin or other tissues w/ SC infarction.
Interaction
Cholestatic hepatitis may occur when taken concomitantly w/ ticlopidine. Increased risk of bleeding w/ other anticoagulants (e.g. argatroban, dabigatran, heparin), antiplatelet agents (e.g. aspirin, cilostazol, clopidogrel), NSAIDs (e.g. celecoxib, diclofenac, ibuprofen), serotonin reuptake inhibitors (e.g. citalopram, paroxetine, venlafaxine). Increased INR w/ CYP2C9 (e.g. amiodarone, capecitabine, cotrimoxazole), CYP1A2 (e.g. aciclovir, allopurinol, ciprofloxacin) and CYP3A4 (e.g. alprazolam, amlodipine, atorvastatin) inhibitors. Decreased INR w/ CYP2C9, CYP1A2 and CYP3A4 inducers.
Potentially Fatal: Increased risk of bleeding w/ fibrinolytic drugs (e.g. streptokinase and alteplase).
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