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What is Coumadin
WarfarinThe Generic name of this drug
Treatment SummaryWarfarin is a blood-thinning drug used to stop the formation and movement of blood clots. It was originally designed as a pesticide, but is now the most commonly prescribed oral anticoagulant in North America. Warfarin can cross the placenta during pregnancy which can lead to fetal bleeding, miscarriage, premature birth, stillbirth, or death of the baby. Other potential side effects include necrosis, purple toe syndrome, osteoporosis, calcification of valves and arteries, and drug interactions. Warfarin does not change the viscosity of blood, but it blocks the body’s
Coumadinis the brand name
Coumadin Overview & Background
Brand Name
Generic Name
First FDA Approval
How many FDA approvals?
Coumadin
Warfarin
1995
557
Approved as Treatment by the FDA
Warfarin, otherwise known as Coumadin, is approved by the FDA for 11 uses which include Deep Vein Thrombosis (DVT) and prophylaxis of Thromboembolic event .Deep Vein Thrombosis (DVT)
prophylaxis of Thromboembolic event
Systemic Embolism
prophylaxis of Venous thrombosis
Stroke
Pulmonary Embolism
cardiac valve replacement
Pulmonary Embolism
Atrial Fibrillation
Heart Attack
Disease
Effectiveness
How Coumadin Affects PatientsWarfarin is a blood thinning drug used to prevent dangerous blood clots. It is commonly prescribed to people with deep vein thrombosis or atrial fibrillation, as well as those with cardiac valve disease or valve replacements. The main goal of warfarin therapy is to keep potentially dangerous clots from forming and travelling to the lungs, heart, or brain. However, warfarin can also cause negative side effects, such as cholesterol microemboli leading to visual disturbances, acute kidney injury, central nervous system ischemia, and purple or blue toe syndrome. In some cases, it can also cause warfar
How Coumadin works in the bodyWarfarin is a drug that stops the production of vitamin K in the body. Vitamin K helps create proteins in the blood that are responsible for clotting. Without these proteins, the blood cannot clot, and you may experience excessive bleeding. Warfarin binds to vitamin K epoxide reductase and prevents the recycling of vitamin K, creating an anticoagulation effect. To reverse this effect, you need to take more vitamin K, either through supplements or by removing the inhibition of the enzyme. It takes about 2 days for new clotting proteins to be made in the liver. Taking antibiotics can also reduce the amount of vitamin K
When to interrupt dosage
The measure of Coumadin is contingent upon the identified condition, including Pulmonary Embolism, Atrial Fibrillation and Heart Attack. The portion of dosage fluctuates as per the method of delivery specified in the table below.Condition
Dosage
Administration
Systemic Embolism
, 3.0 mg, 4.0 mg, 10.0 mg, 1.0 mg, 2.5 mg, 5.0 mg, 2.0 mg, 6.0 mg, 7.5 mg, 2.0 mg/mL, 0.0075 mg
, Oral, Tablet, Tablet - Oral, Intravenous, Powder, for solution, Powder, for solution - Intravenous, Injection, powder, lyophilized, for solution, Injection, powder, lyophilized, for solution - Intravenous
Pulmonary Embolism
, 3.0 mg, 4.0 mg, 10.0 mg, 1.0 mg, 2.5 mg, 5.0 mg, 2.0 mg, 6.0 mg, 7.5 mg, 2.0 mg/mL, 0.0075 mg
, Oral, Tablet, Tablet - Oral, Intravenous, Powder, for solution, Powder, for solution - Intravenous, Injection, powder, lyophilized, for solution, Injection, powder, lyophilized, for solution - Intravenous
Transient Ischemic Attack (TIA)
, 3.0 mg, 4.0 mg, 10.0 mg, 1.0 mg, 2.5 mg, 5.0 mg, 2.0 mg, 6.0 mg, 7.5 mg, 2.0 mg/mL, 0.0075 mg
, Oral, Tablet, Tablet - Oral, Intravenous, Powder, for solution, Powder, for solution - Intravenous, Injection, powder, lyophilized, for solution, Injection, powder, lyophilized, for solution - Intravenous
Deep Vein Thrombosis (DVT)
, 3.0 mg, 4.0 mg, 10.0 mg, 1.0 mg, 2.5 mg, 5.0 mg, 2.0 mg, 6.0 mg, 7.5 mg, 2.0 mg/mL, 0.0075 mg
, Oral, Tablet, Tablet - Oral, Intravenous, Powder, for solution, Powder, for solution - Intravenous, Injection, powder, lyophilized, for solution, Injection, powder, lyophilized, for solution - Intravenous
prophylaxis of Venous thrombosis
, 3.0 mg, 4.0 mg, 10.0 mg, 1.0 mg, 2.5 mg, 5.0 mg, 2.0 mg, 6.0 mg, 7.5 mg, 2.0 mg/mL, 0.0075 mg
, Oral, Tablet, Tablet - Oral, Intravenous, Powder, for solution, Powder, for solution - Intravenous, Injection, powder, lyophilized, for solution, Injection, powder, lyophilized, for solution - Intravenous
Atrial Fibrillation
, 3.0 mg, 4.0 mg, 10.0 mg, 1.0 mg, 2.5 mg, 5.0 mg, 2.0 mg, 6.0 mg, 7.5 mg, 2.0 mg/mL, 0.0075 mg
, Oral, Tablet, Tablet - Oral, Intravenous, Powder, for solution, Powder, for solution - Intravenous, Injection, powder, lyophilized, for solution, Injection, powder, lyophilized, for solution - Intravenous
prophylaxis of Thromboembolic event
, 3.0 mg, 4.0 mg, 10.0 mg, 1.0 mg, 2.5 mg, 5.0 mg, 2.0 mg, 6.0 mg, 7.5 mg, 2.0 mg/mL, 0.0075 mg
, Oral, Tablet, Tablet - Oral, Intravenous, Powder, for solution, Powder, for solution - Intravenous, Injection, powder, lyophilized, for solution, Injection, powder, lyophilized, for solution - Intravenous
Disease
, 3.0 mg, 4.0 mg, 10.0 mg, 1.0 mg, 2.5 mg, 5.0 mg, 2.0 mg, 6.0 mg, 7.5 mg, 2.0 mg/mL, 0.0075 mg
, Oral, Tablet, Tablet - Oral, Intravenous, Powder, for solution, Powder, for solution - Intravenous, Injection, powder, lyophilized, for solution, Injection, powder, lyophilized, for solution - Intravenous
cardiac valve replacement
, 3.0 mg, 4.0 mg, 10.0 mg, 1.0 mg, 2.5 mg, 5.0 mg, 2.0 mg, 6.0 mg, 7.5 mg, 2.0 mg/mL, 0.0075 mg
, Oral, Tablet, Tablet - Oral, Intravenous, Powder, for solution, Powder, for solution - Intravenous, Injection, powder, lyophilized, for solution, Injection, powder, lyophilized, for solution - Intravenous
Pulmonary Embolism
, 3.0 mg, 4.0 mg, 10.0 mg, 1.0 mg, 2.5 mg, 5.0 mg, 2.0 mg, 6.0 mg, 7.5 mg, 2.0 mg/mL, 0.0075 mg
, Oral, Tablet, Tablet - Oral, Intravenous, Powder, for solution, Powder, for solution - Intravenous, Injection, powder, lyophilized, for solution, Injection, powder, lyophilized, for solution - Intravenous
Heart Attack
, 3.0 mg, 4.0 mg, 10.0 mg, 1.0 mg, 2.5 mg, 5.0 mg, 2.0 mg, 6.0 mg, 7.5 mg, 2.0 mg/mL, 0.0075 mg
, Oral, Tablet, Tablet - Oral, Intravenous, Powder, for solution, Powder, for solution - Intravenous, Injection, powder, lyophilized, for solution, Injection, powder, lyophilized, for solution - Intravenous
Stroke
, 3.0 mg, 4.0 mg, 10.0 mg, 1.0 mg, 2.5 mg, 5.0 mg, 2.0 mg, 6.0 mg, 7.5 mg, 2.0 mg/mL, 0.0075 mg
, Oral, Tablet, Tablet - Oral, Intravenous, Powder, for solution, Powder, for solution - Intravenous, Injection, powder, lyophilized, for solution, Injection, powder, lyophilized, for solution - Intravenous
mechanical heart valve
, 3.0 mg, 4.0 mg, 10.0 mg, 1.0 mg, 2.5 mg, 5.0 mg, 2.0 mg, 6.0 mg, 7.5 mg, 2.0 mg/mL, 0.0075 mg
, Oral, Tablet, Tablet - Oral, Intravenous, Powder, for solution, Powder, for solution - Intravenous, Injection, powder, lyophilized, for solution, Injection, powder, lyophilized, for solution - Intravenous
Warnings
Coumadin possesses twenty-seven contraindications, meaning it should not be administered when encountering any of the conditions given in the table below.Coumadin ContraindicationsCondition
Risk Level
Notes
Malignant Hypertension
Do Not Combine
Hemorrhagic tendencies
Do Not Combine
Pericardial effusion
Do Not Combine
Anesthesia procedures
Do Not Combine
Hemorrhage
Do Not Combine
Eclampsia
Do Not Combine
high risk Patient Non-Compliance
Do Not Combine
Aorta
Do Not Combine
Lumbar Punctures
Do Not Combine
Disease
Do Not Combine
gastrointestinal active ulceration
Do Not Combine
Bacterial Endocarditis
Do Not Combine
Ulcer
Do Not Combine
inadequate access to laboratory facilities
Do Not Combine
Spontaneous abortion
Do Not Combine
Gastrointestinal Hemorrhage
Do Not Combine
Cerebral Aneurysm
Do Not Combine
Antepartum magnesium sulfate prophylaxis
Do Not Combine
Pericarditis
Do Not Combine
Hemorrhage
Do Not Combine
Heart Valve Prosthesis
Do Not Combine
Nervous system surgery
Do Not Combine
eye surgery
Do Not Combine
large open surfaces
Do Not Combine
Anesthesia procedures
Do Not Combine
Choroid Hemorrhage
Do Not Combine
Ulcer
Do Not Combine
Procedure with high risk of uncontrollable bleeding
Do Not Combine
Common Coumadin Drug Interactions
Drug Name
Risk Level
Description
Abemaciclib
Major
The metabolism of Abemaciclib can be increased when combined with Warfarin.
Albutrepenonacog alfa
Major
The therapeutic efficacy of Albutrepenonacog alfa can be decreased when used in combination with Warfarin.
Alectinib
Major
The metabolism of Alectinib can be increased when combined with Warfarin.
Aminophylline
Major
The metabolism of Aminophylline can be increased when combined with Warfarin.
Andexanet alfa
Major
The therapeutic efficacy of Andexanet alfa can be decreased when used in combination with Warfarin.
Coumadin Toxicity & Overdose RiskThe toxic dose of warfarin varies between different animal species, with the lowest toxic dose being 1-2 mg/kg/day in humans. Symptoms of an overdose may include bleeding from the nose, mouth, and other parts of the body, as well as low blood pressure. Warfarin is a known teratogen, posing risk to a fetus when taken during pregnancy. Infants exposed to warfarin in utero may experience nasal hypoplasia, malformations of the heart and limbs, low birth weight, and other abnormalities. Warfarin has been found to not be present in breast milk, though infants should
Coumadin Novel Uses: Which Conditions Have a Clinical Trial Featuring Coumadin?
Currently, 301 active studies are assessing the potential of Coumadin to address Atrial Fibrillation, Disease and Pulmonary Embolism.Condition
Clinical Trials
Trial Phases
cardiac valve replacement
0 Actively Recruiting
mechanical heart valve
0 Actively Recruiting
Deep Vein Thrombosis (DVT)
35 Actively Recruiting
Phase 4, Phase 2, Phase 3, Not Applicable, Early Phase 1, Phase 1
Transient Ischemic Attack (TIA)
8 Actively Recruiting
Not Applicable, Phase 4
Systemic Embolism
2 Actively Recruiting
Not Applicable
prophylaxis of Thromboembolic event
0 Actively Recruiting
Atrial Fibrillation
146 Actively Recruiting
Not Applicable, Phase 2, Phase 4, Phase 1, Phase 3, Early Phase 1
Pulmonary Embolism
35 Actively Recruiting
Not Applicable, Phase 4, Phase 3, Early Phase 1, Phase 1, Phase 2
Heart Attack
53 Actively Recruiting
Phase 4, Phase 2, Phase 3, Not Applicable, Phase 1, Early Phase 1
Pulmonary Embolism
0 Actively Recruiting
prophylaxis of Venous thrombosis
0 Actively Recruiting
Disease
0 Actively Recruiting
Stroke
11 Actively Recruiting
Not Applicable, Phase 1, Phase 2, Phase 3
Coumadin Reviews: What are patients saying about Coumadin?
5Patient Review
5/18/2017 So far, my mother has not had any more clots since being put on warfarin. I find the blood tests a little irritating, and she sometimes gets annoyed about not being able to eat green leafy vegetables; but all things considered, this medication has been really effective with no notable side effects.
5Patient Review
2/8/2016 No issues whatsoever. It's very important to have routine blood tests while taking this medication.
5Patient Review
12/22/2014 Though it can be tricky to keep the dosage regulated, this drug is still very effective. It's helped me a lot and I follow dietary restrictions closely.
4.7Patient Review
10/19/2015 I experienced some rectal bleeding while taking this medication. I would not recommend taking it at the same time as other medications.
4.7Patient Review
7/23/2014 This medication has been working well for me for the past five years. However, it is important to be mindful of what kinds of food and drugs can interfere with its efficacy.
4Patient Review
8/28/2015 I've been managing Antiphosfolipid Antibodies Syndrome for two decades now. I've had three clots - one in my arm, one in my leg, and one in my heart. I've also had to deal with a lot of side effects like hair loss, memory loss, fatigue, and bruising. Now that I can test at home, life is much easier. Watching vitamin K is difficult but necessary. All in all, I've learned to live with it and still enjoy life!
3.7Patient Review
5/27/2014 I find that my levels increase when I eat too many vegetables, so I would rather diet than take this drug.
3.3Patient Review
4/24/2015 I take this medication at bedtime, which can vary depending on my schedule. Almost immediately after taking it, I get a really foul taste in my mouth that lasts until morning. Additionally, since starting this medication, I've been having more pain in my joints (knees, hips, shoulders). My INR is where it's supposed to be according to my doctor, but I wonder how common these side effects are for other people who take this medication.
2.3Patient Review
8/7/2018 I started taking this medication last month, and since then I've been feeling dizzy, experiencing headaches, and having difficulty walking due to a loss of balance. My doctor says it isn't the medication, but if it's not the medication than it must be from the head injury I sustained from these blackout spells. Either way, something is clearly wrong.
2Patient Review
10/13/2014 I have had a lot of bruising with this medicine. I don't know if my pain in my legs and knees is because of the med or if it is because I have had 4 surgeries on left knee and 2 on right, but I hurt really bad. I hope I can get off this med soon.
2Patient Review
3/6/2022 I experienced a lot of adverse effects while taking this medication, including headaches, gum pain, nausea, muscle pain, hair loss, and tingling in my feet. I'm curious to know if anyone else has had similar experiences.
2Patient Review
5/2/2021 I really didn't have a good experience with this medication. I was constantly getting headaches, and the summer heat made them even worse. My appetite decreased and the food I did eat tasted terrible. It took six months to get regulated, and it felt like hell every week when I got injected.
1.7Patient Review
1/10/2016 I stopped taking this medication after gradually losing color vision. When I did, my vision returned to normal; however, as soon as I started taking the medication again, I lost color vision once more. After doing some research, I discovered that an enlarged optic nerve is a side effect of this drug.
Patient Q&A Section about coumadin
These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.What are Coumadin side effects?
"You may have easy bruising and bleeding, nausea, vomiting, stomach pain, bloating, gas, or an altered sense of taste."
Answered by AI
What is Coumadin used for?
"Warfarin is a prescription medication used to prevent harmful blood clots from forming or growing larger. Beneficial blood clots prevent or stop bleeding, but harmful blood clots can cause a stroke, heart attack, deep vein thrombosis, or pulmonary embolism."
Answered by AI
What is the most common side effect of Coumadin?
"The blood thinner warfarin (sold under the brand name Coumadin) can cause a variety of side effects, including nausea, vomiting, diarrhea, and abdominal pain. The most common side effect, however, is bleeding, which can be fatal."
Answered by AI
Why is Coumadin being taken off the market?
"Coumadin's manufacturer, Bristol-Myers Squibb, has announced the discontinuation of all strengths of the drug due to an unexpected manufacturing issue. The decision is not based on safety or efficacy concerns."
Answered by AI