Warin
Generic Name
Warfarin Sodium
Manufacturer
Specific manufacturer varies by region (e.g., Incepta Pharmaceuticals, Bangladesh for Warin)
Country
Bangladesh (for Warin brand)
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| warin 2 mg tablet | ৳ 2.00 | ৳ 20.00 |
Description
Overview of the medicine
Warin 2 mg tablet contains Warfarin Sodium, an oral anticoagulant used to prevent and treat blood clots. It is a vitamin K antagonist that interferes with the synthesis of clotting factors in the liver.
Uses & Indications
Dosage
Adults
Initial dose typically 2-5 mg orally once daily for 1-2 days, then adjusted based on INR to maintain a therapeutic range (usually 2.0-3.0).
Elderly
Lower initial doses (e.g., 2 mg/day) and careful INR monitoring recommended due to increased sensitivity and risk of bleeding.
Renal_impairment
No specific dose adjustment required, but close monitoring of INR is crucial due to potential for altered drug clearance or increased bleeding risk.
How to Take
Take orally once daily, at the same time each day, with or without food. Consistent timing is important.
Mechanism of Action
Warfarin inhibits the synthesis of vitamin K-dependent clotting factors (II, VII, IX, X) and anticoagulant proteins (Protein C and S) by interfering with the regeneration of vitamin K from its inactive form (vitamin K epoxide). This leads to a decrease in the levels of functional clotting factors, thus prolonging blood clotting time.
Pharmacokinetics
Onset
Anticoagulant effect within 24-72 hours; peak effect in 5-7 days.
Excretion
Metabolites excreted in urine and feces.
Half life
Variable, 20-60 hours (mean 40 hours).
Absorption
Rapid and complete oral absorption.
Metabolism
Primarily hepatic, by CYP2C9, CYP1A2, CYP2C19, CYP3A4 enzymes.
Side Effects
Contraindications
- Pregnancy (Category X), active bleeding or hemorrhagic tendencies (e.g., hemophilia, thrombocytopenia).
- Recent or contemplated surgery (especially CNS, eye), severe uncontrolled hypertension, peptic ulcer disease.
- Cerebral aneurysm, pericarditis, bacterial endocarditis, or conditions with increased risk of hemorrhage.
Drug Interactions
NSAIDs, Aspirin
Increased risk of bleeding.
Barbiturates, Rifampin
Decrease Warfarin effect, decreasing INR.
Amiodarone, Fluconazole
Significant potentiation of Warfarin, requiring dose reduction.
Antibiotics (e.g., Metronidazole, Trimethoprim/Sulfamethoxazole)
Potentiate Warfarin effect, increasing INR.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Overdose symptoms include excessive bleeding (e.g., nosebleeds, blood in urine/stools, bruising). Management involves discontinuing Warfarin, administering Vitamin K (oral or intravenous), and in severe cases of bleeding, fresh frozen plasma or prothrombin complex concentrates may be given.
Pregnancy & Lactation
Warfarin is contraindicated in pregnancy (Category X) due to the risk of fetal warfarin syndrome and hemorrhage. Use during lactation is generally discouraged, though some studies suggest minimal transfer to breast milk; caution and close monitoring are advised.
Side Effects
Contraindications
- Pregnancy (Category X), active bleeding or hemorrhagic tendencies (e.g., hemophilia, thrombocytopenia).
- Recent or contemplated surgery (especially CNS, eye), severe uncontrolled hypertension, peptic ulcer disease.
- Cerebral aneurysm, pericarditis, bacterial endocarditis, or conditions with increased risk of hemorrhage.
Drug Interactions
NSAIDs, Aspirin
Increased risk of bleeding.
Barbiturates, Rifampin
Decrease Warfarin effect, decreasing INR.
Amiodarone, Fluconazole
Significant potentiation of Warfarin, requiring dose reduction.
Antibiotics (e.g., Metronidazole, Trimethoprim/Sulfamethoxazole)
Potentiate Warfarin effect, increasing INR.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Overdose symptoms include excessive bleeding (e.g., nosebleeds, blood in urine/stools, bruising). Management involves discontinuing Warfarin, administering Vitamin K (oral or intravenous), and in severe cases of bleeding, fresh frozen plasma or prothrombin complex concentrates may be given.
Pregnancy & Lactation
Warfarin is contraindicated in pregnancy (Category X) due to the risk of fetal warfarin syndrome and hemorrhage. Use during lactation is generally discouraged, though some studies suggest minimal transfer to breast milk; caution and close monitoring are advised.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Pharmacies, Hospitals
Approval Status
Approved (Globally and by DGDA in Bangladesh)
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensively studied in numerous clinical trials for various thromboembolic conditions since its introduction. Ongoing research focuses on genetic factors influencing dose requirements.
Lab Monitoring
- International Normalized Ratio (INR) – regularly, especially during initiation and dose adjustments.
- Complete Blood Count (CBC) – to monitor for anemia and platelet levels.
- Liver function tests – periodically.
Doctor Notes
- Emphasize strict INR monitoring and patient education on diet and drug interactions.
- Always assess bleeding risk factors before initiating and throughout therapy.
- Consider genetic testing for challenging cases to guide dosing.
Patient Guidelines
- Take Warfarin exactly as prescribed; do not change the dose without consulting your doctor.
- Always carry identification indicating you are taking Warfarin.
- Report any signs of bleeding (unusual bruising, red/dark urine, black/tarry stools, severe headaches) immediately to your doctor.
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 resume your regular schedule. Do not double doses. Contact your doctor if you frequently miss doses.
Driving Precautions
Warin does not directly affect the ability to drive or operate machinery. However, patients should be aware of the risk of bleeding from minor injuries.
Lifestyle Advice
- Maintain a consistent diet, especially regarding foods rich in Vitamin K. Avoid sudden changes in diet.
- Limit or avoid alcohol consumption, as it can interfere with Warfarin's effect.
- Be cautious with activities that may cause injury or bleeding; use a soft toothbrush and electric razor.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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