Warfarin

Warfarex tablets are indicated for:

• prevention and treatment of deep vein thrombosis and pulmonary embolism;
• secondary prevention of myocardial infarction and prevention of thromboembolic complications (stroke or systemic embolism) after myocardial infarction;
• prevention of thromboembolic complications in patients with atrial fibrillation, damage to the heart valves or with prosthetic heart valves;
• prevention of fast-passing ischemic attacks and stroke.

Structure

Active substance: warfarin;

1 tablet contains 5 mg of sodium warfarinate (in the form of sodium warfarinate clathrate);

Excipients: lactose, monohydrate; microcrystalline cellulose; crospovidone; magnesium stearate; indigo carmine (E 132) (for 3 mg tablets) and crimson 4R (E 124) (for 5 mg tablets).

Contraindications

• hypersensitivity to warfarin or to any excipient of the drug;
• clinically established bleeding;
• tendency to bleeding (von Willebrand disease, hemophilia, thrombocytopenia and impaired platelet function);
• in order to avoid the development of the risk of severe bleeding within 72 hours after extensive surgery, for 48 hours in the postpartum period;
• severe renal and hepatic insufficiency or cirrhosis;
• untreated or uncontrolled arterial hypertension;
• recent intracranial bleeding; conditions causing intracranial bleeding, for example, cerebral artery aneurysm, aortic aneurysm;
• tendency to faint (fall);
• surgery in the central nervous system or in the eyes;
• gastrointestinal or renal bleeding and their complications;
• diverticulosis;
• malignant tumors;
• varicose veins of the esophagus;
• infectious endocarditis, pericarditis or pericardial effusion;
• a condition in which therapy cannot be carried out safely enough (for example, dementia, psychosis, alcoholism);
• lumbar puncture.

Mode of application

Warfarex must be used at the same time.

The dose of Warfarex is determined by the doctor for each patient individually, guided by the INR indicators of prothrombin.

The range of targeted INR in oral anticoagulant therapy.

Prevention of thromboembolic complications in patients with prosthetic heart valves: INR - 2.5–3.5. Other indications: INR - 2.0–3.0.

Application features

Pregnant women

Contraindicated.

Children

Anticoagulant therapy in children should be carried out as directed and under the supervision of pediatricians.

Drivers

Does not affect.

Overdose

Symptoms: bleeding, bleeding.

Treatment: in mild cases with a gradual overdose, a dose reduction or discontinuation of warfarin treatment is usually sufficient until the INR returns to the target level. In acute drug overdoses, gastric emptying is not recommended due to the risk of bleeding. Activated carbon should be reused to avoid absorption and enterohepatic recycling of warfarin. When using activated carbon parenterally (iv), vitamin K should be administered. If bleeding develops, warfarin should be discontinued using vitamin K (5–10 mg intravenously), coagulation factor concentrate, or fresh frozen plasma. If further anticoagulation is necessary, the use of vitamin K in a dose of more than 10 mg should be avoided. Otherwise, the patient may be resistant to warfarin therapy for 2 weeks.

Side effects

• From the nervous system: subdural hematoma, fever.
• From the circulatory and hematopoietic system: hemorrhage, coumarin necrosis, staining of the toes in purple, purpura, eosinophilia, vasculitis, anemia, decreased hematocrit.
• From the respiratory system, chest and mediastinum: calcification of the trachea, hematorax.
• From the gastrointestinal tract: nausea, vomiting, vomiting of blood, diarrhea, pain in the abdomen, gastrointestinal bleeding, bleeding from the rectum, melena.
• From the hepatobiliary system: a reversible increase in the activity of liver enzymes, cholestatic hepatitis, jaundice.
• On the part of the skin and subcutaneous tissue: reversible alopecia, rashes, urticaria, itching, eczema, erythematic edema of the skin, leading to ecchymosis, heart attack and necrosis of the skin.
• From the genitourinary system: hematuria, priapism.
• General: allergic reactions (usually in the form of skin rashes), nephritis, urolithiasis, tubular necrosis.

Interaction

Fibrinolytics, such as streptokinase and alteplase, are contraindicated in patients taking warfarin.

It is necessary to avoid the simultaneous use of warfarin or to use with caution under close clinical and laboratory control with thrombin inhibitors, unfractionated heparins and their derivatives, low molecular weight heparin, fondaparin, rivaroxaban, glycoprotein IIb / IIIa receptor antagonists, prostamocitonin inhibitor, prostaratsiklin,.

Excessive alcohol consumption against the background of liver failure potentiates the effect of warfarin. The quinine contained in Tonic water can also cause an increase in the effect of warfarin.

Storage conditions

Store in a dark place at a temperature not exceeding 25 ° C.

Keep out of the reach of children.

Shelf life is 5 years.