Diseases of the cardiovascular system are the most common in most people on the planet. Vascular problems or bleeding disorders are recorded in every second cardiologist patient. But many people before the planned inspection did not even suspect about the existing problems. Nevertheless, the disease does not recede and becomes the cause of the development of other pathologies. It is especially dangerous not to normalize blood coagulation. If the problem is left to chance, then in the future it is fraught with the formation of blood clots and the development of a heart attack, which can result in death. Doctors strongly recommend that everyone regularly undergo preventive examinations by specialists and should they take the recommended medications if they encounter problems with blood coagulation. One of the most effective and often prescribed is Warfarin. Contraindications to the medicine are also available, so self-administration is prohibited.
Medication Functions
The main purpose of the drug is to prevent coagulation and thickening of blood. In this process, vitamin K takes an active part, which is inhibited by the action of the active substances of the drug. As a result, blood becomes more diluted and the risk of blood clots is reduced, which can cause serious health problems. "Warfarin", whose action is aimed at the process of blood coagulation, is used to control blood clots in the veins.
The article further describes the complete indications for taking the medicine, detailed instructions for taking it, as well as compatibility with other medicines and reviews of patients who were prescribed this drug. It has "Warfarin" and contraindications, which the specialist will always take into account, but a person who is far from medicine will not be able to accurately determine. Therefore, for examination and appointment, it is important to always contact a cardiologist.
Hematopoiesis Information
To ensure normal blood formation in the body of each person, two systems function simultaneously. One contributes to the rapid coagulation of blood, preventing its loss in injuries and wounds. Another provides an anticoagulant function, preventing clots from forming. Due to this, normal flow conditions are created for veins and other vessels. As a result, internal organs and cells receive oxygen and nutrients in full.
If a person is healthy, then these two systems act equivalently. But as soon as the balance is disturbed, a person immediately sees a change in his health. For example, a patient may begin to be disturbed by nosebleeds, or on examination it turns out that there is a greater tendency to form blood clots.
Doctors know that the blood clotting system is always more active. With the balance of all functions in the body, a person does not notice this. But in case of violation of any systems, everything can change and the patient will be at risk for developing a stroke or heart attack. Such patients, a specialist may prescribe Warfarin. Treatment should correct the disturbed balance of systems and prevent dangerous complications.
special instructions
Patients who are prescribed anticoagulants always undergo regular examinations. After all, these drugs, which also includes Warfarin, contribute to blood thinning. To find out the current state of hematopoiesis, an analysis for INR or an international normalized ratio is prescribed. At the same time, regularity is important and skipping can be dangerous for the health and life of patients. Typically, such an examination is carried out once every four months. Therein lies the difficulty in prescribing Warfarin, and the contraindications to its use are a rather extensive list, which we will consider further.
But pharmacology is constantly being improved, and now there are worthy analogues that do not require constant monitoring of the state of the blood. But only a doctor can prescribe an analogue, because they also have many contraindications.
Characteristic of Warfarin
"Warfarin" is an anticoagulant, which the doctor will prescribe one of the first for problems with blood formation. The instruction for the drug is quite complete, but does not contain information about analogues. Therefore, if it is impossible to use the tool, recommendations for its replacement must be obtained from a specialist.
The medication in question is a fairly effective drug of its kind and at the same time has a budget price. The cost depends on the number of tablets in the package. They are convex on both sides and have a bevel in the middle, with which it is easy to divide the pill in half. The color of the tablets is white, but a yellowish tint is allowed. Packed in small plastic bottles that contain 50 or 100 pills.
Current composition
The action of "Warfarin" is based on its active ingredient, warfarin sodium. 2.5 mg of active ingredient are needed per tablet. Auxiliary ingredients are also present, but they do not affect the therapeutic effect and are necessary for the formation of the pill. The following can be distinguished:
- magnesium stearate;
- talc;
- silica;
- lactose;
- corn starch;
- povidone;
- calcium dihydrate.
Cardiologists note that the mechanism of action of the active component is quite simple. Vitamin K is synthesized in the liver, which is blocked under the influence of the drug. As a result, blood liquefies and blood clots are minimized. But do not wait for a lightning effect. After taking the medicine, its effect begins on the 3-5th day. This is due to the lack of work of the active substance directly in the bloodstream.
It is worth noting that getting into the stomach, the tablets are absorbed very quickly. Withdrawal of the drug occurs through the kidneys. But the half-life is long, so the effect of taking it lasts some more time after the medication is canceled.
Indications for admission
Before "Warfarin" is prescribed, indications and contraindications are necessarily compared. The rationale for taking the pills will be a specific diagnosis, which is supported by clinical research data. Of course, only a doctor should prescribe this medicine, but it will be useful for the patient to read the indications:
- venous thrombosis, manifested by constant relapses;
- phlebeurysm;
- hemorrhoids;
- cerebral vascular thrombosis;
- thrombosis caused by surgery;
- pulmonary embolism in the initial stage or at a repeated stage;
- damage to the heart valves;
- prevention of recurrent myocardial infarction;
- atrial fibrillation;
- thromboembolic complications caused by transplantation of blood vessels or implantation of an artificial valve.
Before using Warfarin, the indications and contraindications must be carefully studied. The drug can be used in the treatment of thrombosis of varying severity. Moreover, therapy consists in medical treatment, but specialists can recommend an operative solution to the problem.
Also, the drug is often used as a restorative during operations during which funds were used to stop natural blood flow.
What are the contraindications for the use of "Warfarin"
There are many states that prescribe a complete ban on the use of this medication. All of them must be taken into account in order not to get significant side effects. Experts focus on the fact that a fatal outcome is possible if all the rules of use are not observed. It is forbidden to use the medication if the patient has the following diagnoses and conditions:
- aneurysm;
- hemorrhagic stroke;
- recent surgery on the eyes and craniocerebral;
- bacterial endocarditis;
- the presence of acute bleeding or the risks of their discovery;
- thrombocytopenia;
- severe hypertension;
- pericardial effusion ;
- severe liver or kidney disease.
It is forbidden to prescribe this drug to people prone to alcohol dependence. Also a contraindication is individual sensitivity to any component of the pill and the presence of psychosis in the patient. What are the contraindications for the use of Warfarin, should be known to all potential patients in order to avoid possible health problems.
Note to pregnant women
Through laboratory studies, it was found that the active substance of the drug in question easily penetrates the placental barrier. Therefore, if "Warfarin" is prescribed, pregnancy should be excluded. If you do not take into account such a ban, then the developing fetus can:
- abnormalities in the growth and development of bone tissue;
- optic atrophy;
- cataract;
- congenital blindness;
- physical and mental retardation in development;
- microcephaly.
Therefore, a categorical contraindication for Prema "Warfarina" is the pregnancy of a woman at any time. Changes that may be in the development of the fetus significantly exceed the possible benefits. If it is necessary to treat the level of blood coagulability in these patients, fundamentally different means are selected, but the main therapy is carried out after delivery.
Use of the drug to lactating women
"Warfarin" in contraindications for use does not contain a ban on admission to nursing women. Clinical trials recorded that the active ingredient passes into breast milk, but is excreted in an inactive form. During treatment with the drug of a nursing patient, children did not record changes in the level of blood coagulation. Therefore, medication during lactation is allowed, but therapy should be carried out under the full supervision of a specialist.
Unpleasant consequences on the background of taking
Quite a lot of feedback from doctors and patients has Warfarin. Contraindications and side effects excite the patient most of all. During the reception, you can encounter unpleasant symptoms, so you should know about the consequences in advance. But it is worth noting that the following phenomena are rare and are associated exclusively with individual reactions. Tablets can provoke the appearance of undesirable moments on the part of different body systems:
- skin reactions in the form of jaundice, skin necrosis, urticaria, itching or rash;
- diarrhea may develop with prolonged use or malfunction of the gastrointestinal tract;
- with kidney problems, nephritis or urolithiasis can be triggered;
- vasculitis;
- with injuries and cuts, increased bleeding and, as a result, anemia are recorded;
- abdominal pain, nausea and vomiting;
- tubular necrosis;
- some patients report hair loss.
Before prescribing Warfarin, contraindications and side effects are always taken into account by the doctor. Tablets can provoke an individual reaction associated with hypersensitivity to the active ingredient. In this case, skin reactions in the form of a rash are noticed. In addition, the liver begins to produce enzymes in an increased amount, which causes cholestatic hepatitis. But these reactions are reversible, and the patient's condition returns to normal after discontinuation of the drug.
Instructions for use of the medicine
Take "Warfarin" is necessary after a full examination and appointment as a specialist. The cardiologist should identify the indications and write the full course. It is important to strictly follow the recommendations and, in particular, to drink pills always at the same time. Reception is not burdensome, because tablets should be taken once a day.
Strict dosing requires Warfarin. The abstract prescribes an initial dosage of 2.5 to 5 mg per day. Further treatment will depend on the level of the INR assay score.
The instructions have basic information that helps in determining the dosage, but they are designed mainly for the specialist. We give them more simplified.
- If previously a person has not taken Warfarin, 5 mg (two tablets) make up the standard norm per day.
- If a routine examination before surgery revealed a high risk of a blood clot, then tablets are prescribed for their prevention in 2-3 days.
- With vein thrombosis, supportive therapy is carried out aimed at stabilizing the condition in order to obtain a moderate anticoagulant effect.
- A more powerful effect is achieved in preparation for prosthetic heart valve surgery, with thromboembolism and acute venous thrombosis.
- However, as practice shows, in the acute course of venous thrombosis, Warfarin is prescribed only as part of complex therapy. Essential medicines include heparin-based products. In this case, the effect of taking can be expected only after 5-7 days.
- Anticoagulants are much worse tolerated by patients in old age. Therefore, in such a group of patients, the dosage is usually recommended two times lower than the usual norm. Also, the amount of active substance should be reduced in the treatment of weakened people.
Usually, Warfarin has good reviews. Bleeding, however, is one of the side effects that should always be considered when treating with a drug. The duration of therapy is determined only by the cardiologist, but abrupt withdrawal of the drug is always possible.
Instructions Notes
An INR test is always prescribed before prescribing and during treatment with Warfarin. Contraindications and special instructions contains an annotation.
- Control analysis is carried out throughout the treatment. Usually follow the scheme and appoint an examination for the 2-4-8th week of treatment.
- The medication contains warfarin, the absorption of which can be affected by almost any medication and even food.
- Conducting therapy with the help of "Warfarin", contraindications and side symptoms should be studied thoroughly and discussed with a doctor. So, the medication is not prescribed for people with lactase deficiency due to intolerant substances that make up the pill. Also, the drug should not be used for glucose-galactose malabsorption and for patients with galactosemia.
- It is worth considering that the action of the active component is enhanced if the patient has decompensated heart failure, liver damage, fever and hyperthyroidism. In contrast, with hypothyroidism, the effect of treatment can be significantly reduced.
Interaction with other drugs
The activity of the active substance is affected by almost all other drugs that the patient takes. Therefore, the doctor must identify concomitant diagnoses and adjust the treatment regimen taking into account the use of other medications. Information on compatibility and prohibition of simultaneous reception is given in the instructions, but only a specialist can understand it more precisely. However, it is useful for the patient to also read the following information.
1. Anticoagulants reduce their effectiveness under the influence of diuretics. It is known that a pronounced hypovolemic effect can lead to increased blood coagulation.
2. May provoke extensive bleeding drugs such as:
- valproic acid;
- cytochrome inhibitors;
- dipyridamole.
3. If necessary, in therapy with chloramphenicol, treatment with Warfarin is temporarily discontinued.
4. The activity of warfarin is influenced by such substances as:
- colestramine;
- barbiturates;
- vitamin K;
- mianserin;
- dicloxacillin;
- retinoids;
- carbamazelin;
- rifampecin;
- phenazole;
- Sucralfate.
5. Significantly reduces the effectiveness of warfarin conventional paracetamol. Therefore, in order to prescribe a drug for headache and temperature, it is important to consult a doctor in this case.
6. The use of laxatives can lead to bleeding. Therefore, co-administration is possible only with regular clinical tests for blood coagulation. Experts note that with small bleeding and the possibility of frequent laboratory examination, medication can be continued, but significantly reducing the dosage. However, in the absence of constant monitoring, such a combination is prohibited.
7. Some medicines significantly enhance the effect of taking Warfarin. Therefore, when taking the following substances together, the doctor adjusts the dosage regimen:
- allopurinol;
- anabolic steroid;
- heparin;
- disulfiram;
- ketoconazole;
- clofibrate;
- clarithromycin;
- metronidazole;
- nalidixic acid;
- paroxetine;
- quinine;
- cimetidine.
Taking all of the above drugs together with Warfarin requires an INR control two weeks before the intended intake and every two weeks during treatment.
Product compatibility
The drug "Warfarin" also has contraindications for food. The specialist will necessarily write out not only the course of treatment, but also the recommended diet. . - , .
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Products that promote excitement of the nervous system should be completely excluded from the menu. They include;
- all power engineers;
- alcohol and alcohol-based drugs;
- cocoa and coffee.
It is worth paying attention to the calorie content of dishes. If "Warfarin" is prescribed, the products are listed as contraindications that contain many calories. It is best to consume food in small portions every two hours. In this case, the last meal should be made no later than eight o’clock in the evening.
There are a few more recommendations about the diet:
- All products must be warm. Cold and hot banned.
- You can not eat spicy and fatty.
- Fried foods are not recommended.
- The best option is to cook in an oven or slow cooker.
Recommended Diet
In therapy with Warfarin, more fiber-rich foods should be consumed. These include vegetables and fruits. Carbohydrates are shown only in the form of pasta from durum flour and cereals, cooked on water. There should not be any rolls and bread from white flour in the diet.
It is necessary to include foods rich in vitamin K in the diet:
- prunes
- spinach;
- asparagus;
- broccoli.
When undergoing treatment with Warfarin, it is important to consume protein-rich foods. The menu should have eggs, boiled breast and butter. Will be useful dishes with the addition of cilantro, parsley and dill.
Prohibited Products
If the patient decides to compose his own menu, then you need to know which products are prohibited. It is important to show the approximate diet to the doctor for possible correction and useful recommendations.
When taking the medicine, you can not use the following products;
- ketchup, mustard and mayonnaise;
- any fast food;
- smoked meats (meat and fish);
- fats
- pastes;
- coffee;
- garlic;
- sorrel (due to oxalic acid);
- any baking;
- biscuits and sweets;
- carbonated drinks;
- canned food.
Of course, they are not advised to change the diet radically either. But if the diet is not followed, the effect of taking the medicine can be significantly reduced or the tablets will lead to extensive bleeding.
Doctors also advise during therapy to limit exercise, not to attempt to lose weight. Acceptance of any dietary supplements is prohibited.
Patient reviews about the drug
Those who are prescribed "Warfarin" study contraindications and reviews on the preparation of patients with genuine interest. The medication has a fairly serious activity, therefore, without the recommendation of a doctor and clinical tests, it is not used. But in any case, the responses of other patients are always interesting.
Many are prescribed a medicine for detecting arrhythmias, because the disease contributes to the risk of blood clots. Some patients are scared by numerous contraindications and the need for ongoing examinations. But after dispelling doubts by the doctor, patients begin to take one tablet a day. As a result, the control examination revealed that the blood condition improved, and side effects were not observed. However, systematic monitoring is necessary because Warfarin is a powerful coagulant and can lead to bleeding that is difficult to control.
Cardiologists often prescribe a remedy after bouts of atrial fibrillation. In this case, the condition quickly normalizes, the patient ceases to be at risk. It is noted that the effect of the reception does not affect the well-being, unpleasant symptoms are also not observed. Of course, you have to follow a diet, but from the list of allowed products you can make a very decent menu.
But it is worth considering all contraindications and drug compatibility. Cases from the practice of doctors show that if you do not inform the specialist about taking other medicines, do not undergo a regular blood test and do not follow a diet, then extensive bleeding is possible. The least formidable signs of drug incompatibility or misuse of the drug are nosebleeds and numerous hematomas throughout the body.
Many patients who take pills only as prescribed by a doctor and report all changes in the body, note an improvement. But sometimes, to adjust the composition of the blood, a dosage reduction is required.
Overdose symptoms
Warfarin may cause chronic intoxication if the recommended standards are not followed. In this case, the symptoms of this condition are:
- characteristic blood streaks in feces and urine;
- bleeding gums and nosebleeds;
- heavy menstruation;
- extensive and uncontrollable bleeding even with small cuts;
- bruises, bruises, and bruises all over the body.
If the symptoms are minor, then the doctor should adjust the dosage and reduce the daily amount of medication used. With more global problems, the drug is completely canceled, a prophylactic dose of vitamin K is prescribed until the condition is completely normalized.
For bleeding that threatens severe loss, transfusions of plasma or other components of fresh blood may be prescribed.
Conclusion
"Warfarin" is prescribed only by a doctor for strict indications. The effect of taking it can lead to undesirable consequences if you take the drug unreasonably. Any cardiologist will always preliminarily conduct a special analysis to identify the state of the blood and subsequently will also monitor the entire treatment process.
Do not ignore side effects. The patient may be disturbed by nosebleeds, heavy menstruation, bruising on the body, and nausea. Frequent and hair loss in patients receiving. It is important to inform the doctor about all unpleasant symptoms in time to adjust the treatment or completely cancel the medication. An overdose or rash reception can cause bleeding, which will be difficult to stop, and the loss of important elements.
Children may be prescribed the drug, but its administration should be carried out under close supervision and constant monitoring of the liver and blood composition.
Categorical contraindications for taking "Warfarin" will always be taken into account by a specialist. The patient alone will not be able to determine all the factors. Therefore, this drug is not used independently, but only after the appointment.