warfarin - Aspen Pharmacare

1 Page 1warfarin96 Merrindale Drive (Locked Bag 268)Croydon VIC 3136, Tel: (03) 9839 2800 Last revised: March 2010 COUMADINMAREVANIMPORTANT INFORMATION FOR PATIENTS ( warfarin sodium) warfarin ()AuthorsDr Leanne ChalmersLecturer in Therapeutics and Pharmacy PracticeProfessor Gregory PetersonAssociate Dean Research, Professor of PharmacyAssociate Professor Luke BereznickiDeputy Head, School of Medicine, Associate Head, PharmacyAssociate Professor in Pharmacy PracticePharmacy, School of Medicine and Unit for Medication OutcomesResearch and Education (UMORE)University of TasmaniaContact details:Dr Leanne ChalmersPharmacy, School of Medicine, University of Tasmania, Private Bag 26, Hobart TAS 7001 Email: note that we are unable to provide individual warfarin dosing advice.

2 Your doctor (or the healthcare professional who manages your warfarin therapy) knows your medical history and is in the best position to offer you dosing advice. If you are unable to contact your usual healthcare professional, the emergency department of your local hospital may be able to assist PRESENTATION 2 ABOUT THIS BOOKLET 5 warfarin AN OVERVIEW 6 WHAT IS warfarin ? 8A BIT MORE INFORMATION ABOUT ATRIAL FIBRILLATION 9 HOW DO YOU KNOW warfarin IS WORKING? INR TESTING 13 TAKING warfarin SAFELY 16 KEEPING YOUR INR STABLE 18 warfarin AND BLEEDING 31 WHERE CAN YOU FIND MORE INFORMATION? 35page 1tABLEt PrEsENtAtIoNThere are two brands of warfarin available in Australia - Coumadin and Marevan .Coumadin and Marevan are similar but NOT the same.

3 There is no guarantee that you will obtain the same effect if you swap between brands. Unless directed by your doctor, you should always keep taking the brand you were first Coumadin and Marevan come in three different colours and each colour corresponds to a different strength. The strength is indicated by the number stamped on the tablet. Bottles of Coumadin also have coloured lids and labels that match the tablet surE You ArE tAKING thE rIGht tABLEt BY ChECKING thE CoLour AND 2 You are taking: (cross out the brand that does not apply)*Name:Address:Telephone:Doctor: Telephone:Brown 1 mgBlue 3 mgPink 5 mgLight Tan 1 mgLavender 2 mgGreen 5 mgCOUMADIN ( warfarin sodium)MAREVAN ( warfarin sodium)page 3page 4 PAtIENt INForMAtIoNReason for taking warfarin : warfarin brand:Intended duration of warfarin therapy:Date of commencement:Target INR range:Blood type:page 5 ABout thIs BooKLEtYour doctor has prescribed you a medicine called warfarin .

4 warfarin is an anticoagulant , or anti-clotting medicine that is used to help prevent harmful blood clots from forming or to prevent worsening of existing clots. It has been used worldwide for over 60 years and is taken by many hundreds of thousands of people every therapy is highly effective but there is a lot you need to know to get the most benefit from it. This booklet is designed to help you to understand warfarin and to offer you some useful hints and tips on how you can work with your healthcare team to obtain the best possible results while taking first, this information may seem a bit overwhelming, so keep this booklet in a safe place and feel free to read through it as often as you like.

5 Remember that your doctors, nurses, pharmacists and other healthcare professionals are all there to help don t be afraid to ask any questions you may 6 warfarin AN oVErVIEW warfarin is an anti-clotting medicine, or anticoagulant . It is used to prevent or treat unwanted blood clots within blood vessels. How long you will need to take warfarin depends on the condition being treated and may vary from person to person. Your doctor will adjust your warfarin dose to find the right balance between bleeding and clotting. This is measured using a blood test called the International Normalised Ratio , or INR . The ideal INR range for most people is between 2 and 3.

6 INR tests may be required as often as every day or every second day when you first start warfarin , but generally only once or twice a month when your INR is stable. Make sure you have your INR tests done every time they are ordered by your doctor. Contact your doctor or laboratory after each INR test and keep a record of your INR results in the record section of this booklet. Bring this booklet to your next doctor visit. page 7 Take your warfarin at approximately the same time each day, with or without food. Take the exact warfarin dose prescribed by your doctor. Some people might need to take different doses every second day or on different days of the week. Try to avoid missing doses of warfarin .

7 It is a good idea to keep a record of the doses you take each day (this booklet can be used). If you do miss a dose, never take a double dose to catch up. Other medicines can affect how well warfarin works. Always talk to your doctor or pharmacist before starting or stopping any prescription or over-the-counter medicines, herbal medicines, vitamins or health supplements. Ensure all members of your healthcare team (including doctors, specialists, dentists, nurses and pharmacists) know that you are taking warfarin . Maintain a healthy, well-balanced diet, with a consistent intake of green, leafy vegetables. Limit your alcohol intake. The major side effect of warfarin is bleeding.

8 Watch yourself for signs of bleeding and if you are concerned, contact your doctor as soon as possible. Think about ways you can reduce your risk of bleeding on a day-to-day 8hoW DoEs warfarin WorK? warfarin is an anti-clotting medicine, or anticoagulant a medicine that increases the time it takes for your blood to clot. Some people call it a blood thinner but your blood won t actually look or feel any different while you are taking helps to stop unwanted clots from forming inside blood vessels or to treat them if they occur. A clot will not usually form inside a blood vessel, but if it does it is called a thrombosis . A thrombosis can cause a stroke, a heart attack or a vein blockage in the legs or lungs.

9 warfarin helps to prevent or treat thrombosis by making it more difficult for the blood to form a reasons why people may need to take warfarin include: Atrial fibrillation ( AF ), an irregular heartbeat that can cause blood clots and strokes; Blood clots in the legs (a deep vein thrombosis or DVT ) or lungs (a pulmonary embolism or PE );page 9 Certain blood clotting problems (for example, antiphospholipid syndrome, protein C deficiency and Factor V Leiden); and Mechanical heart doctor will be able to tell you why you are taking warfarin and how long you will need to take it. This varies according to the condition being treated and may vary from person to BIt MorE INForMAtIoN ABout AtrIAL FIBrILLAtIoNIf you are taking warfarin because you have atrial fibrillation ( AF ), you are not alone.

10 It has been estimated that up to half a million Australians suffer from AF. You may not be aware of your AF on a daily basis some people have no obvious signs or symptoms, but that does not mean that it is not there. Other people may notice heart palpitations, breathlessness, fainting or chest pain as a result of their AF. Unfortunately, people with AF have a much higher risk of suffering a stroke than people whose hearts beat in a normal rhythm. In fact, people with AF are about five times more likely to suffer a stroke, and the strokes they suffer are often page 10more severe. This is even true for people who have what is called paroxysmal AF episodes of AF that come and AF, the top chambers of the heart (the atria ) beat very fast and irregularly.