Warfarin 1 S.P.M Medicine Short -term treatment of venous thrombosis and acute pulmonary embolism (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications S.P.M Joint Stock Company

Uses

indications

Warfarin 1mg medicine indicated in the following cases:

Short -term treatment: Venous thrombosis and non -acute congestion, at the beginning of treatment in combination with coordination with heparin

Blood prevention for patients must be immobile prolonged after surgery. Heart disease is at risk of vascular congestion such as ventricular vibration, replacement of heart valves, people with ischemic disease, brain vasoconstriction. Coronary artery disease (angina, myocardial infarction).

Warfarin prevents prothrombin synthesis (II coagulation factor), Proconvertin (factor VII), anti hemophilia B element (IX factor) and Stuart - Prower element (factor X) by preventing the activity of vitamin K inherently necessary for the synthesis of these coagulopathy elements in the liver.

The sale time of these factors is very different, the effect of Warfarin's blood clotting usually starts to appear within 24 hours, but it may take 3-4 days to achieve the highest effect. Blood prevention effects are usually reached after 5 days.

If you need to work quickly, use heparin at the beginning of using warfarin until you achieve the desired results.

Dynamic pharmacokinetics

After drinking, warfarin is absorbed quickly and completely. All anticoagulant drugs are strongly linked to plasma proteins (98 - 99%).

Half life eliminates 22 - 35 hours, mainly through the kidneys after metabolism in the liver by cytochrom P450.

This metabolism may be inhibited by some drugs such as inhibited cimetidine, which risks dangerous bleeding.

Some other drugs inhibit the diameting of warfarin such as propafenon, increasing blood warfarin levels about 40% and increasing prothrombin time in the corresponding way.

Amiodaron increases the concentration of warfarin, because Amiodaron has a very long selling time, up to 50 days, so it can cause severe interaction after treatment.

always attach importance to the risk of drug interaction. After stopping using warfarin, prothrombin returns to normal within 4-5 days.

Metabolic substances have no anticoagulant effect, and excretion in urine after reabsorption from bile.

Before taking Warfarin 1 S.P.M Medicine Short -term treatment of venous thrombosis and acute pulmonary embolism (3 blisters x 10 tablets)

How to use

Warfarin 1mg tablets for oral tablets. Must take the drug at the same time specified in the days.

Dosage

Dosage is determined for each person,

Dosage depends on INR (International standardization ratio).

The first dose usual 5 - 10 mg/day for the first 2 days, then adjust based on the results of the INR.

Elderly people often use low initial dose.

When needed anticoagulants quickly use heparin in the first days (intravenous or subcutaneous)

Warfarin treatment may either either or at the same time with heparin, or start after heparin.

Maintenance dose: Most patients are maintained at a dose of 2 - 10 mg/day. Treatment time depends on each person. Typically, anticoagulant therapy must be prolonged when the risk of obstruction is over.

Inr's range of oscillation is recommended:

INR = 2.0 - 3.0: Rooms of the thrombosis - jams for internal or surgical patients are at high risk; Treatment of close venous thrombosis and pulmonary embolism, body congestion in patients with atrial fibrillation, valve disease, biological valve or acute myocardial infarction.

INR = 3.0 - 4.5: Prevention of congestion in people who place a mechanical heart valve or in the body of the body congestion recurrence.

Periodic PT/INR monitoring: PT/INR must be determined before treatment. In the first 2 weeks, determine daily or 2 to 3 times per week. Then, every month in the patient was balanced or 1/2 month, if necessary.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose? For vitamin K, oral or injection 5 - 10 mg.

In an emergency, call the 115 emergency center immediately or go to the nearest local health station.

What to do when you forget 1 dose?

Do not use two doses of drugs (forgotten and next dose) at the same time.

Side Effects

Unwanted effects when using Warfarin 1mg that you may encounter.

Common, ADR> 1/100:

Bleeding.

Digestive: diarrhea.

Skin: Red rash.

circulatory: Vascular inflammation.

The risk of severe harmful reactions, including life -threatening, is due to the dosage that does not correspond to prothrombin time (Quick time). Therefore, continuous monitoring of prothrombin time is absolutely necessary for patients treated with warfarin.

Interaction with other drugs is another risk factor must also be carefully paid.

Before starting treatment, it is always necessary to eliminate the risk of physical bleeding, such as ulcers, tumors in the gastrointestinal tract.

Notify the doctor with unwanted effects when using the drug.

Instructions for handling ADR:

The main risk of Warfarin therapy can cause bleeding anywhere on the body. The base avoids overdose of Warfarin, necessarily monitoring Inr as recommended.

If an overdose is overdosed, it is necessary to handle (see more overdose management sections).

If Inr is above treatment but less than 5, it is necessary to reduce the dose or stop until the INR returns to the level of treatment.

If Inr is equal to or above 5.0 but below 9.0, warfarin must be stopped. If the risk of bleeding is increased, there is a way for oral phytomenadion 1 - 2.5 mg or so that up to 5 mg.

If Inr is equal to or greater than 9.0, it is necessary to stop warfarin and give Phytomenadion 2.5 - 5 mg.

If there is any massive bleeding, warfarin must be stopped, and slowly intravenously phytomenadion and fresh plasma, special solution containing element II, VII, IX and X, or the recombinant factor VIIA.

If Inr is at the level of treatment that has bleeding, other causes such as kidney or gastrointestinal disease must be found.

Skin necrosis and soft tissue are rare but very heavy. The reason is that due to thrombosis but the disease is still unknown.

Patients with protein C deficiency are at high risk of this condition. Coumarin must be stopped when skin damage and must give vitamin K.

Must give heparin against coagulation. Fresh frozen plasma or concentrated solution C can also work.

If necrosis, surgery.

Before starting treatment, it is always necessary to eliminate the risk of real bleeding, such as ulcers, tumors in the digestive tract.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Warfarin 1mg contraindications in the following cases:

Patients do not cooperate well (do not comply with physician's instructions).

Malignant high blood pressure. Central.

Be cautious when using

Some factors affecting the effects of the drug: diet, living environment.

closely monitor people with liver disease, severe heart failure, atrial fibrillation, hyperthyroidism, fever. Elderly people are at risk of severe injury (eg thigh fracture) and physiological changes in subcutaneous tissues and joints, can cause uncontrolled bleeding.

The following factors can increase the effects of warfarin and need to reduce the dose: People with weight loss, elderly people, seriously ill, kidney failure, vitamin K -deficiency.

Factors may need to increase the maintenance dose: weight gain, IA melting, vomiting, using lots of vitamin K, fat and some drugs. Need to do the necessary tests when changing drugs.

The effect of warfarin is reversed vitamin K.

Effect of drugs on drivers and operating machinery

has not recorded any cases that affect the operation of the train machinery when using this drug, if you need more information, please consult a physician

used for pregnant and lactating women

Warning ratings

au tga Pregnancy category: d

us FDA Pregnancy Category: Na

Pregnancy:

Not used for pregnant women. Warfarin also increases the risk of bleeding in the mother in the middle 3 months and the last 3 months of pregnancy.

Breastfeeding period:

Warfarin does not excrete in breast milk should be used for nursing mothers.

Drug interaction

drug interactions may affect the activity of the drug or cause side effects. Should notify the doctor or pharmacist a list of drugs and functional foods you are using. Do not use or increase or decrease the dose of the drug without the guidance of a doctor.

Must be very cautious when taking oral anticoagulants, in combination with other drugs.

The drug increases the effects of warfarin:

Amiodaron, Amitryptylin/Nortriptylin, Steroid Lam Dong HDA, Azapropazon, Bezafibrat, Cefamandol, Cloral Hydrate, Cloramphenicol, Cimetidine, Clofibrat, Co- Trimoxazol, Danazol, Dextropropoxyphen, Dextrothinin, Dipyrothol, Dyridamol, Dipyrrothol, Dipyrrothol, Dyridamol, Dyridamol, Dipyrrothol, Dipyrrothol, Dipyrrothol, Dipyrrothol, Dipyrrothol, Dipyrrothol, Dipidamol, Dipyrrothol, Dyridamol, Dipyrrothol, Dipyrrothol, Dipyrrothol, Dyridamol, Dipidamol, Dipyrrothol, Diprothol, Dipidamol, Dipidamol, Diprothol, Dipyrrothol, Dipyrropolin erythromycin, Feprazon, Latamoxef, Metronidazol, Miconazol, Neomycin, Oxyphenbutazon, Glucagon, Phenformin, Phenylbutazon, Phenyramidol, Quinidine, Salicylate, Sulfonamid (for example: Sulfaphenazol, SulfinPyrazon), tamoxi, tamox, Tolbutamid and triclofos, 3 -round anti -tram citrus drugs, urinase, vitamin E, anti -influenza vaccine.

The drug increases or decreases the effects of warfarin: phenytoin, acth, corticoid.

Medicines reduce the effect of warfarin:

Alcohol (alcoholism), Aminoglutethimid, Barbiturat, Carbamazepin, ethlorvyol, Glutethimid, Griseofulvin, Dicontalphenazon, Methqualon, Primidone, Rifampicin Oral contraceptive pills containing Oestrogens, Spironolacton, Sucralfat, Vitamin K.

Storage

Leave a cool place, avoid light, temperature below 30⁰C.

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