Farin
Generic Name
Warfarin
Manufacturer
General Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| farin 1 mg tablet | ৳ 1.00 | ৳ 10.00 |
Description
Overview of the medicine
Farin 1 mg Tablet contains Warfarin, an anticoagulant used to prevent and treat blood clots in various conditions such as deep vein thrombosis, pulmonary embolism, and atrial fibrillation.
Uses & Indications
Dosage
Adults
Individualized dosage based on INR. Initial dose typically 2-5 mg orally once daily. Maintenance dose adjusted to achieve target INR, usually 2-10 mg daily.
Elderly
Lower initial doses (e.g., 2 mg) often recommended due to increased sensitivity and higher risk of bleeding.
Renal_impairment
No dose adjustment necessary for renal impairment, but careful monitoring of INR is advised.
How to Take
Take orally once daily, preferably at the same time each day, with or without food. Do not skip doses or take double doses.
Mechanism of Action
Warfarin works by inhibiting the vitamin K epoxide reductase enzyme, which is responsible for reactivating vitamin K. This leads to a depletion of active vitamin K, consequently impairing the synthesis of vitamin K-dependent clotting factors II, VII, IX, and X, as well as anticoagulant proteins C and S.
Pharmacokinetics
Onset
Anticoagulant effect becomes apparent within 24-72 hours, with full therapeutic effect achieved in 5-7 days.
Excretion
Excreted as inactive metabolites in urine and feces.
Half life
Plasma half-life ranges from 20 to 60 hours, with an average of 40 hours.
Absorption
Rapidly and completely absorbed orally, with peak plasma concentrations occurring within 2-8 hours.
Metabolism
Extensively metabolized in the liver primarily by cytochrome P450 enzymes (CYP2C9, CYP1A2, and CYP3A4).
Side Effects
Contraindications
- Active bleeding or bleeding tendencies (e.g., gastrointestinal ulceration, intracranial hemorrhage)
- Recent or contemplated major surgery
- Severe uncontrolled hypertension
- Pregnancy (Category X)
Drug Interactions
Amiodarone
Significantly increases warfarin's anticoagulant effect, requiring dose reduction.
Vitamin K supplements/foods
Can decrease warfarin's anticoagulant effect.
NSAIDs (e.g., Aspirin, Ibuprofen)
Increased risk of bleeding by inhibiting platelet function and/or gastrointestinal irritation.
Antibiotics (e.g., Metronidazole, Ciprofloxacin)
Can potentiate warfarin's effect by affecting gut flora and vitamin K production, or by inhibiting warfarin metabolism.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include excessive bleeding (e.g., nosebleeds, blood in urine/stool, heavy menstrual bleeding, excessive bruising). Management involves discontinuing warfarin, administering Vitamin K to reverse its effects, and in severe cases, fresh frozen plasma (FFP) or prothrombin complex concentrate (PCC) to rapidly replenish clotting factors.
Pregnancy & Lactation
Warfarin is contraindicated during pregnancy due to the risk of fetal malformations and hemorrhage (Category X). It can be used with caution during lactation as it is minimally excreted into breast milk and unlikely to harm the infant.
Side Effects
Contraindications
- Active bleeding or bleeding tendencies (e.g., gastrointestinal ulceration, intracranial hemorrhage)
- Recent or contemplated major surgery
- Severe uncontrolled hypertension
- Pregnancy (Category X)
Drug Interactions
Amiodarone
Significantly increases warfarin's anticoagulant effect, requiring dose reduction.
Vitamin K supplements/foods
Can decrease warfarin's anticoagulant effect.
NSAIDs (e.g., Aspirin, Ibuprofen)
Increased risk of bleeding by inhibiting platelet function and/or gastrointestinal irritation.
Antibiotics (e.g., Metronidazole, Ciprofloxacin)
Can potentiate warfarin's effect by affecting gut flora and vitamin K production, or by inhibiting warfarin metabolism.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include excessive bleeding (e.g., nosebleeds, blood in urine/stool, heavy menstrual bleeding, excessive bruising). Management involves discontinuing warfarin, administering Vitamin K to reverse its effects, and in severe cases, fresh frozen plasma (FFP) or prothrombin complex concentrate (PCC) to rapidly replenish clotting factors.
Pregnancy & Lactation
Warfarin is contraindicated during pregnancy due to the risk of fetal malformations and hemorrhage (Category X). It can be used with caution during lactation as it is minimally excreted into breast milk and unlikely to harm the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture, specific expiry date is printed on the packaging.
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Generic
WHO Essential Medicine
YesClinical Trials
Warfarin has been extensively studied in numerous clinical trials for its efficacy and safety in preventing and treating thromboembolic events across various patient populations and conditions. Landmark trials have established its role in atrial fibrillation and venous thromboembolism.
Lab Monitoring
- International Normalized Ratio (INR) – regularly to monitor anticoagulant effect and adjust dosage.
- Complete Blood Count (CBC) – to check for anemia due to bleeding.
Doctor Notes
- Emphasize the critical importance of patient education regarding warfarin therapy, including strict adherence, bleeding precautions, and diet.
- Regular and timely INR monitoring is non-negotiable for safe and effective warfarin management.
- Be vigilant for drug-drug and drug-food interactions; review all concomitant medications and dietary habits.
Patient Guidelines
- Take your medicine exactly as prescribed by your doctor and do not change the dose without consulting them.
- Attend all scheduled blood tests (INR) to monitor your treatment.
- Report any signs of bleeding (e.g., unusual bruising, blood in urine/stool, heavy periods) immediately to your doctor.
- Inform all healthcare providers (including dentists) that you are taking warfarin before any procedures or new medications.
Missed Dose Advice
If you miss a dose, take it as soon as you remember on the same day. If it's almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Farin 1 mg Tablet is not known to directly impair the ability to drive or operate machinery. However, if you experience dizziness or any severe side effects, avoid driving or operating machinery.
Lifestyle Advice
- Maintain a consistent diet regarding Vitamin K-rich foods; do not make drastic changes to your diet without consulting your doctor.
- Avoid excessive alcohol consumption, as it can increase the risk of bleeding.
- Be cautious with activities that may cause injury or falls to minimize the risk of bleeding.
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