Coumadin (warfarin)

Coumadin (warfarin) belongs to the class of medications called anticoagulants. Coumadin is sometimes referred to as a "blood thinner," although it does not actually thin the blood. Coumadin (warfarin) helps to prevent blood clots from forming or from getting bigger, but it does not dissolve blood clots. Coumadin is used for the treatment of blood clots in the veins, arteries, lungs, and heart. It is also used to prevent clots for people with conditions that put them at an increased risk of developing blood clots (e.g., some abnormal heart rhythms, leg circulation problems).

Blood clots in the circulation are dangerous because they can cause medical problems such as heart attacks, stroke, and pulmonary embolism. Coumadin (warfarin) helps to reduce blood clotting within 24 hours of taking the medication. The full effect may take 72 to 96 hours to occur. Coumadin (warfarin) works by partially blocking the re-use of vitamin K in your liver. Vitamin K is needed to make clotting factors that help the blood to clot and prevent bleeding. Vitamin K is found naturally in foods such as leafy, green vegetables and certain vegetable oils. If you are taking Coumadin, you may continue to eat these foods, but do not make any drastic changes to your diet.

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Warfarin

Crystalline warfarin sodium, is an anticoagulant which acts by inhibiting vitamin K-dependent coagulation factors. Crystalline warfarin sodium occurs as a white, odorless, crystalline powder, is discolored by light and is very soluble in water; freely soluble in alcohol; very slightly soluble in chloroform and in ether. Coumadin for Injection is supplied as a sterile, lyophilized powder, which, after reconstitution with 2.7 ml sterile Water for Injection, contains: Warfarin sodium: 2 mg/ml; Sodium Phosphate, Dibasic, Heptahydrate: 4.98 mg/ml; Sodium Phosphate, Monobasic, Monohydrate: 0.194 mg/ml Sodium Chloride: 0.1 mg/ml; Mannitol: 38.0 mg/ml; Sodium Hydroxide, as needed for pH adjustment to: 8.1 to 8.3.

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Canadian Coumadin

Coumadin is available in injectable and tablet form.

Injection: Each vial contains warfarin 5.4 mg. Nonmedicinal ingredients: mannitol, sodium chloride, sodium hydroxide (pH adjustment from 8.1 to 8.3), sodium phosphate dibasic heptahydrate and sodium phosphate monobasic monohydrate, and water for injection.

Tablets:
1 mg: Each pink, scored tablet with "COUMADIN" over "1" on one side and "DuPont" on the other, contains warfarin 1 mg. Nonmedicinal ingredients: D&C Red No. 6 Barium Lake, lactose anhydrous, magnesium stearate, and pregelatinized tapioca starch.
2 mg: Each lavender, scored tablet with "COUMADIN" over "2" on one side and "DuPont" on the other, contains warfarin 2 mg. Nonmedicinal ingredients: FD&C Blue No. 2 Aluminum Lake, FD&C Red No. 40 Aluminum Lake, lactose anhydrous, magnesium stearate, and pregelatinized tapioca starch.
2.5 mg: Each green, scored tablet with "COUMADIN" over "2.5" on one side and "DuPont" on the other, contains warfarin 2.5 mg. Nonmedicinal ingredients: D&C Yellow No. 10 Aluminum Lake, FD&C Blue No. 1 Aluminum Lake, lactose anhydrous, magnesium stearate, and pregelatinized tapioca starch.
3 mg: Each tan, scored tablet with "COUMADIN" over "3" on one side and "DuPont" on the other, contains warfarin 3 mg. Nonmedicinal ingredients: FD&C Blue No. 2 Aluminum Lake, FD&C Red No. 40 Aluminum Lake, FD&C Yellow No. 6 Aluminum Lake, lactose anhydrous, magnesium stearate, and pregelatinized tapioca starch.
4 mg: Each blue, scored tablet with "COUMADIN" over "4" on one side and "DuPont" on the other, contains warfarin 4 mg. Nonmedicinal ingredients: FD&C Blue No. 1 Aluminum Lake, lactose anhydrous, magnesium stearate, and pregelatinized tapioca starch.
5 mg: Each peach-coloured, scored tablet with "COUMADIN" over "5" on one side and "DuPont" on the other, contains warfarin 5 mg. Nonmedicinal ingredients: FD&C Yellow No. 6 Aluminum Lake, lactose anhydrous, magnesium stearate, and pregelatinized tapioca starch.
6 mg: Each teal, scored tablet with "COUMADIN" over "6" on one side and "DuPont" on the other, contains warfarin 6 mg. Nonmedicinal ingredients: FD&C Blue No. 1 Aluminum Lake, FD&C Yellow No. 6 Aluminum Lake, lactose anhydrous, magnesium stearate, and pregelatinized tapioca starch.
10 mg: Each white, scored tablet with "COUMADIN" over "10" on one side and "DuPont" on the other, contains warfarin 10 mg. Nonmedicinal ingredients: lactose anhydrous, magnesium stearate, and pregelatinized tapioca starch. There is no dye in this product.

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Coumadin Side Effects

Coumadin (warfarin) is usually very well tolerated. The most common side effects of Coumadin were:

  • intolerance to cold
  • diarrhea
  • loss of appetite
  • nausea or vomiting
  • stomach cramps or pain

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Coumadin Precautions

The most serious risks associated with anticoagulant therapy with sodium warfarin sodium are hemorrhage in any tissue or organ and, less frequently(0.1%), necrosis and/or gangrene of skin and other tissues. The risk of hemorrhage is related to the level of intensity and the duration of anticoagulant therapy. Hemorrhage and necrosis have in some cases been reported to result in death or permanent disability. Necrosis appears to be associated with local thrombosis and usually appears within a few days of the start of anticoagulant therapy. In severe cases of necrosis, treatment through debridement or amputation of the affected tissue, limb, breast or penis has been reported. Careful diagnosis is required to determine whether necrosis is caused by an underlying disease. Warfarin sodium therapy should be discontinued when warfarin sodium is suspected to be the cause of developing necrosis and heparin therapy may be considered for anticoagulation. Although various treatments have been attempted, no treatment for necrosis has been considered uniformly effective. See below for information on predisposing conditions. These and other risks associated with anticoagulant therapy must be weighed against the risk of thrombosis or embolization in untreated cases.

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Coumadin Manufacturer

Coumadin is a registered trademark of Bristol-Myers Squibb.

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