INTRODUCTION

COFARIN 5MG contains Warfarin which belongs to the group of medicines called Oral anti-coagulants. It is used to manage and prevent blood clot formation in the body. It causes blood thinning and improves blood flow through the blood vessels among patients suffering from blood clots or its associated complications (such as atrial fibrillation (irregular heartbeat), myocardial infarction or pulmonary embolism (blood clot in the lungs)). It can also be used to prevent blood clot formation in patients who have valve replacement in their heart.

Before taking COFARIN 5MG inform your doctor if you have any severe liver, kidney, or heart disease. You must also inform your doctor if you have high blood pressure, diabetes, scheduled for any upcoming surgery or had one recently.

Do not take COFARIN 5MG if you have any bleeding disorders or any underlying conditions that can increase the risk of bleeding (such as peptic ulcer, or severe infections of heart, brain, or other organs). Consult your doctor before taking COFARIN 5MG if you are pregnant or breastfeeding.

While taking COFARIN 5MG, avoid consumption of cranberry juice/fruit as it may increase the effects of COFARIN 5MG and causes more blood thinning that required. Also, do not make sudden changes in your diet or eat large amount of foods rich in vitamin K (such as green leafy vegetables or vegetable oils).

COFARIN 5MG may increase your tendency to bleed more. Therefore, avoid indulging yourself in activities that can increase the risk of accidents or injuries (such as sports activities). You must also be cautions while performing day to day activities which involves risk of bleeding such as shaving, cutting nails, or using knifes or any sharp objects.

Inform your doctor immediately if you notice any bloody stools or urine, excessive menstrual bleeding, confusion, blurred vision, or numbness of body parts after taking COFARIN 5MG.

USES OF COFARIN 5MG

• Manages and prevents blood clot formation in the body

HOW COFARIN 5MG WORKS

COFARIN 5MG is an anticoagulant medicine. It reduces the thickness of the blood and helps the blood to flow more easily and smoothly through the blood vessels. It acts by blocking the production of certain blood proteins (Coagulation Factor II, VII, IX, and X, Protein C and S) within the body that are involved in the formation of blood clots. As a result, it causes blood thinning, prolongs clotting time, and prevents the formation of blood clots within the blood vessel.

DIRECTIONS FOR USE

Take COFARIN 5MG as directed by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. Your doctor will decide the dose, duration of therapy, and frequency for you depending on your age, body weight and disease condition.

SIDE EFFECTS OF COFARIN 5MG

HOW TO MANAGE SIDE EFFECTS

Nausea and vomiting:

Take this medicine with, or just after meals. Stick to simple meals. Avoid eating oily and spicy food.

Loss of appetite:

Eat when you are hungry. Try to eat smaller meals more often than usual. Snack only when you're hungry. Always try to have a nutritious snack that is high in calories and protein, such as dried fruit and nuts.

WARNING & PRECAUTIONS

INTERACTIONS

A. Drug-Drug interactions:

Before taking COFARIN 5MG inform your doctor if you are taking any of the following medicines:

• medicines used to manage heart rhythm problems (such as amiodarone, quinidine, propafenone)
• medicines used to manage depression (such as amitriptyline, nortriptyline)
• medicines used to lower cholesterol levels in the blood (Ex. gemfibrozil, clofibrate, bezafibrate, cholestyramine)
• medicines used to manage bacterial infections (such as ciprofloxacin, erythromycin, metronidazole, nalidixic acid, neomycin, aztreonam, cephamandole, co-trimoxazole, chloramphenicol, norfloxacin, rifampicin, sulphonamides, latamoxef, griseofulvin, tetracyclines)
• medicines used to manage fungal infections (Ex. miconazole, fluconazole, ketoconazole)
• medicines used for pain relief (such as ibuprofen, aspirin, oxyphenbutazone, phenylbutazone and feprazone, paracetamol, azapropazone, diflunisal, dextropropoxyphene, phenyramidol)
• medicines used to manage stomach ulcers (such as omeprazole, cimetidine, or sucralfate)
• danazol (a medicine used to manage endometriosis)
• medicines used to manage diabetes (Ex. tolbutamide, glucagon, phenformin)
• salicylates used to manage ulcers (such as choline salicylate)
• allopurinol (a medicine used to manage gout)
• tamoxifen or aminoglutethimide (used for breast cancer or prostate cancer)
• disulfiram (a medicine used to stop alcoholism)
• oral contraceptives (birth control pills) Ex. drospirenone, ethinyl estradiol
• anabolic steroids (used to regulate hormone problems) Ex. testosterone
• corticosteroids (used to manage pain and inflammation) Ex. dexamethasone, betamethasone
• methylphenidate (a CNS stimulant used for ADHD)
• dipyridamole (an anticoagulant used to prevent blood clots)
• medicines used to manage thyroid problems (Ex. thyroxine)
• medicines used to manage epilepsy (Ex. carbamazepine, primidone, or phenytoin)
• vitamin K supplements (used to manage vitamin K deficiency)
• medicines used to reduce anxiety and to induce sleep (such as alprazolam diazepam, clonazepam, midazolam, chloral hydrate or triclofos, ethchlorvynol or glutethimide)
• ACTH (a medicine used to hormone insufficiency)
• St. John’s Wart (herbal medicine used to manage depression)

B. Drug-Food interaction:

While taking COFARIN 5MG, avoid drinking cranberry juice or taking cranberry products as it might increase the activity of COFARIN 5MG and result in more blood thinning that required. If you are taking cranberry juice for manageing bladder infections, you must inform your doctor. Your doctor may ask you to reduce the amount of the juice you drink or might suggest alternative foods for you. Also, avoid taking foods rich with Vitamin K (such as green leafy, vegetables or vegetable oils).

Overdosage:

If you or anyone else accidentally took more COFARIN 5MG, consult your doctor or visit the nearby hospital straight away. Symptoms of overdose includes increased bleeding tendency which can be identified by blood in stools or urine or excessive menstrual bleeding.

SYNOPSIS

MORE INFORMATION

• Keep COFARIN 5MG out of reach from children
• Store COFARIN 5MG at room temperature

FAQs ABOUT COFARIN 5MG

How to take COFARIN 5MG?

Take COFARIN 5MG as prescribed by your physician. Swallow COFARIN 5MG with a glass of water. Do not crush or chew the medicine. Your doctor will decide the correct dose and duration of therapy for you depending upon your age, body weight and disease condition.

How COFARIN 5MG works on my body?

COFARIN 5MG is an anticoagulant medicine. It reduces the thickness of the blood and helps the blood to flow more easily and smoothly through the blood vessels. It acts by blocking the production of certain blood proteins (Coagulation Factor II, VII, IX, and X, Protein C and S) within the body that are involved in the formation of blood clots. As a result, it causes blood thinning, prolongs clotting time, and prevents the formation of blood clots within the blood vessel.

Is COFARIN 5MG safe to use during pregnancy?

COFARIN 5MG is generally not recommended for use in women who are pregnant or planning to become pregnant. However, consult your doctor before taking it.

Can COFARIN 5MG be taken along with alcohol?

No. Avoid consumption of alcohol while taking COFARIN 5MG because it may interfere with its actions and may lead to unwanted side effects.

What can I do if I forget to take COFARIN 5MG on time?

If you forgot to take COFARIN 5MG, take it as soon as you remember. If it’s time for the next dose, skip the missed one and take the next dose on time. Never take a double dose to compensate the missed dose as it could lead to toxicity.

Why am I not supposed to undergo any surgery while taking COFARIN 5MG?

It is because COFARIN 5MG increases your tendency to bleed. As surgeries are always associated with increased risk of bleeding, concomitant use of COFARIN 5MG with surgeries may make you bleed more than usual. Therefore, it is important to inform your doctor about the use of COFARIN 5MG before undergoing any surgeries (including minor surgeries) to avoid the risk of excessive bleeding.

Is COFARIN 5MG safe to use in children?

The safe and effectiveness of COFARIN 5MG have not been established in children and adolescents (aged below 18 years). Therefore, it should be used in children only if prescribed by the physician.

How long should I take COFARIN 5MG?

You should continue to take COFARIN 5MG unless your doctor tells you to stop. Failure to complete the suggested course may not help you in manageing the condition properly.

What are the side effects caused due to long term use of COFARIN 5MG?

COFARIN 5MG may increase the risk of bleeding. It may make you bleed more easily even after minor cuts, injuries, or wounds, and therefore patients must be advised not to undergo even minor surgeries. It may also cause heavy menstrual period or internal bleeding which can be reflected as blood in vomiting, bloody urine or stools, bloody eyes, or blurred vision. To avoid this your doctor would periodically measure your blood clotting time during management with COFARIN 5MG. Therefore, do not miss your regular hospital visits and take this medicine only as advised by your physician. Consult your doctor if you experience any unusual bleeding over a prolonged period.

How long will it take for COFARIN 5MG to start working?

COFARIN 5MG may start working within 1-2 days after administration.

Can COFARIN 5MG cause blood in urine?

Yes. A small trace of blood may be seen in the urine. If bleeding in urine is enormous while using COFARIN 5MG, consult your doctor immediately as it may be life-threatening.

Can I stop taking COFARIN 5MG if my symptoms of the disease subside?

Though the symptoms of your disease subside, do not stop taking COFARIN 5MG unless recommended by your doctor as the disease and its symptoms may worsen back again. Consult your doctor for advice.

Will taking a higher dose of COFARIN 5MG be more effective?

No. Taking a higher dose of COFARIN 5MG may lead to more harm than being effective. It may increase your tendency to bleed more. Therefore, take only the dose recommended by your doctor. If the prescribed dose seems to be not working for you, consult your doctor for advice.

Who should avoid taking COFARIN 5MG?

COFARIN 5MG is not recommended for use in patients with severe liver, kidney, or heart problems. It is also not recommended for use in patients with severe hypertension, bleeding problems, or any underlying conditions that can increase the risk of bleeding (such as peptic ulcer, or severe infections of heart, brain, or other organs). It should not be used in pregnant or breastfeeding women due to increased risk of side effects.

REFERENCES

1. KD. Tripathi. Drugs affecting coagulation, bleeding and thrombosis. Anticoagulants. Essentials of medical pharmacology. 8th edition. 2019. Page – 667-671.

2. Per Wändell, Axel C Carlsson, Martin J Holzmann, Johan Ärnlöv, Sven-Erik Johansson, Jan Sundquist and Kristina Sundquist. Warfarin management and risk of myocardial infarction – a cohort study of patients with atrial fibrillation manageed in primary health care. NIH. National Library of Medicine. National Center for Biotechnology Information. PMC. PubMed Central. October 2017. [Accessed on 5th September 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5417351/

3. Sun Pharmaceutical Industries Europe B.V. Electronic medicines compendium (EMC). [Revised in December 2021] [Accessed on 5th September 2022] https://www.medicines.org.uk/emc/files/pil.3064.pdf

4. Bristol-Myers Squibb Company. U.S. Food and Drug Administration (FDA). [Revised on October 2011] [Accessed on 5th September 2022] https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/009218s107lbl.pdf

USEFUL DIAGNOSTIC TESTS

• Blood Clotting Time