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Drugstore

Popularity: 5% [?]

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Warfarin is an anticoagulant (blood thinner). Warfarin reduces the formation of blood clots.

Warfarin is used to prevent heart attacks, strokes, and blood clots in veins and arteries.

Warfarin may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about warfarin?

This medication can cause birth defects in an unborn baby. Do not use if you are pregnant. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment. Never take a double dose of this medication.

If you need to have a lumbar puncture (spinal tap) or any type of surgery, you may need to temporarily stop using warfarin. Be sure the surgeon knows ahead of time that you are using this medication.

Carry an ID card or wear a medical alert bracelet stating that you are taking warfarin, in case of emergency. Any doctor, dentist, or emergency medical care provider who treats you should know that you are taking warfarin. Warfarin interacts with many other drugs, and these interactions can be dangerous, even fatal. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Do not take aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) unless your doctor has told you to. NSAIDs include celecoxib (Celebrex), diclofenac (Voltaren), ibuprofen (Motrin, Advil), indomethacin, naproxen (Aleve, Naprosyn), piroxicam (Feldene), and others.These medicines can affect blood clotting and may cause serious bleeding in your stomach or intestines.Avoid sudden changes in your diet. Vitamin K decreases the effects of warfarin. Large amounts of vitamin K are found in foods such as liver, broccoli, brussels sprouts, spinach, Swiss chard, coriander, collards, cabbage, and other green leafy vegetables. Do not change the amount of these foods in your diet without first talking to your doctor.

Avoid eating cranberries, drinking cranberry juice, or taking cranberry herbal products.

Avoid drinking alcohol, which can increase some of the side effects of this medication.

What should I discuss with my healthcare provider before taking warfarin?

Do not take this medicine if you have:

• a bleeding disorder such as hemophilia;
• a blood cell disorder such as anemia;
• a stomach ulcer or bleeding in the stomach;
• a history of aneurysm, blood clot, or bleeding in your brain; or
• an infection of your heart, fluid or swelling around your heart.

FDA pregnancy category X. This medication can cause miscarriage, stillbirth, birth defects, or fatal bleeding in an unborn baby. Do not use warfarin if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Use an effective form of birth control while you are using this medication.Before taking warfarin, tell your doctor if you have:

• kidney disease;
• liver disease;
• celiac sprue (an intestinal disorder);
• a recent injury, surgery, or medical emergency;
• high blood pressure;
• severe or uncontrolled diabetes;
• polycythemia vera;
• congestive heart failure;
• cancer;
• overactive thyroid;
• a seizure disorder for which you take an anticonvulsant such as phenytoin (Dilantin) or phenobarbital (Luminal); or
• a connective tissue disorder such as Marfan Syndrome, Sjogren syndrome, scleroderma, rheumatoid arthritis, or lupus.

If you have any of these conditions, you may not be able to use warfarin, or you may need a dosage adjustment or special tests during treatment.

Warfarin may pass into breast milk and cause bleeding problems in the nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Older adults and people who are severely ill or debilitated may have a greater risk of bleeding while taking warfarin. Talk with your doctor about your individual risk. Warfarin should not be given to anyone younger than 18 years old.Tell your doctor (or dentist) that you are taking warfarin before you take an antibiotic or before having surgery.

How should I take warfarin?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from this medication. Follow the directions on your prescription label.

Take each dose with a full glass of water. Take warfarin at the same time every day. Warfarin can be taken with or without food.Your body’s response to warfarin can be affected by your diet, environment, physical well-being, and other medicines or herbal (botanical) products you use.

Avoid dieting to lose weight while taking warfarin. Tell your doctor if your body weight changes for any reason.It is important to take warfarin regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

To be sure this medication is helping your condition, your blood will need to be tested on a regular basis. Do not miss any scheduled visits to your doctor.

If you need to have a lumbar puncture (spinal tap) or any type of dental work or surgery, you may need to temporarily stop using warfarin. Be sure your doctors know ahead of time that you are using this medication.

Carry an ID card or wear a medical alert bracelet stating that you are taking warfarin, in case of emergency. Any doctor, dentist, or emergency medical care provider who treats you should know that you are taking warfarin. Store this medication at room temperature away from heat, moisture, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember, and call your doctor as soon as possible. You may take two doses on the same day, but do not take two doses at the same time.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include bruising, broken blood vessels under the skin, excessive bleeding from cuts or wounds, blood in the urine or stools, and heavy menstrual periods in women.

Warfarin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

• skin changes or discoloration anywhere on your body;
• purple toes or fingers;
• pain in your stomach, back, or sides;
• low fever, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes);
• diarrhea, fever, chills, body aches, flu symptoms;
• easy bruising or bleeding that will not stop;
• blood in your urine;
• black, bloody, or tarry stools;
• nosebleeds, bleeding gums, coughing up blood;
• feeling weak or light-headed;
• sudden headache, confusion, problems with vision, speech, or balance;
• sudden leg or foot pain; or
• sudden numbness or weakness, especially on one side of the body.

Less serious side effects may include:

• nausea, vomiting, stomach pain;
• gas and bloating; or
• hair loss.

This is not a complete list of side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect warfarin?

Warfarin interacts with many other drugs, and these interactions can be dangerous, even fatal. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

Warfarin can interact with the following herbal (botanical) products:

• bromelains;
• coenzyme Q10;
• danshen;
• dong quai;
• garlic;
• ginkgo biloba;
• ginseng; or
• St. John’s wort.

Do not use any of these products without first asking your doctor. Some of these herbal products can cause you to bleed while you are also taking warfarin.

Coumadin

Popularity: 8% [?]

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Verapamil is in a class of drugs called calcium channel blockers. Verapamil relaxes (widens) blood vessels (veins and arteries), which makes it easier for the heart to pump and reduces its workload.

Verapamil is used to treat hypertension (high blood pressure), to treat angina (chest pain), and to control some types of irregular heartbeats.

Verapamil may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about verapamil?

Do not stop taking this medication without first talking to your doctor. If you stop taking the medication, your condition could become worse. Do not crush, chew, or break extended-release forms of verapamil such as generic Covera-HS and Verelan PM. Swallow them whole. Generic verapamil SR, Isoptin SR, and Calan SR may be divided in half but should not be crushed or chewed.

What should I discuss with my healthcare provider before taking verapamil?

Before taking this medication, tell your doctor if you have

• kidney or liver disease;
• other diseases of the heart or blood vessels such as sick sinus syndrome, aortic stenosis, heart failure, heart block, Wolff-Parkinson-White syndrome, coronary artery disease, or low blood pressure; or
• muscular dystrophy.

You may not be able to take verapamil, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Verapamil is in the FDA pregnancy category C. This means that it is not known whether verapamil will be harmful to an unborn baby. Do not take verapamil without first talking to your doctor if you are pregnant or could become pregnant during treatment. Verapamil passes into breast milk and may harm a nursing infant. Do not take verapamil without first talking to your doctor if you are breast-feeding a baby.

How should I take verapamil?

Take verapamil exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water.Verelan, Verelan PM, Calan, Isoptin, Covera-HS, and generic forms of regular-release verapamil can be taken with or without food. Taking the medication with food may reduce stomach upset if it occurs.

Calan SR, Isoptin SR, and generic sustained-release verapamil (verapamil SR) may be more likely to cause stomach upset and should be taken with food to reduce this side effect.Take Covera-HS and Verelan PM at bedtime.

If you have trouble swallowing the Verelan pellet-filled capsules, they can be opened and the contents can be sprinkled onto cold, soft food such as applesauce. This mixture must be swallowed without chewing. Use the mixture immediately. Do not save it for later use. (Do not use this procedure for the Verelan PM capsules.)

Do not crush, chew, or break extended-release forms of verapamil such as Covera-HS and Verelan PM. Swallow them whole. Generic verapamil SR, Isoptin SR, and Calan SR may be divided in half if the tablets are scored, but should not be crushed or chewed.If you are taking Covera-HS, do not be concerned if you find what looks like an undissolved tablet in your stool. This medication is formulated with an outer shell that does not dissolve. This shell allows the medicine to be released slowly into your body before it is passed out in the stool.

It is important to take verapamil regularly to get the most benefit.

Do not stop taking this medication without first talking to your doctor. If you stop taking the medication, your condition could become worse.Grapefruit and grapefruit juice may interact with verapamil. The interaction could lead to potentially dangerous effects. Discuss the use of grapefruit and grapefruit juice with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

Your doctor may want you to have blood tests, blood pressure monitoring, or other medical evaluations during treatment with verapamil to monitor progress and side effects.

Store verapamil at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a verapamil overdose include dizziness, weakness, chest pain, shortness of breath, fainting, an unusually fast or slow heartbeat, coma, slurred speech, and confusion.

What should I avoid while taking verapamil?

Grapefruit and grapefruit juice may interact with verapamil. The interaction could lead to potentially dangerous effects. Discuss the use of grapefruit and grapefruit juice with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

Avoid the use alcohol. Alcohol may further lower blood pressure and increase drowsiness and dizziness while taking verapamil.Follow any recommendations your doctor makes about diet or exercise.

Verapamil side effects

If you experience any of the following serious side effects, stop taking verapamil and contact your doctor immediately or seek emergency medical treatment:

• an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
• an unusually fast or slow heartbeat;
• shortness of breath (heart failure);
• fainting;
• abnormal behavior or psychosis;
• jaundice (yellowing of the skin or eyes); or
• swelling of the legs or ankles.

Other, less serious side effects may be more likely to occur. Continue to take verapamil and talk to your doctor if you experience

• unusual headache, fatigue, or tiredness;
• insomnia or trouble sleeping;
• vivid dreams;
• hair loss;
• nausea or diarrhea; or
• increased urination.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect verapamil?

Before taking this medication, tell your doctor if you are taking any of the following drugs:

• cyclosporine (Sandimmune, Neoral);
• cimetidine (Tagamet, Tagamet HB);
• carbamazepine (Tegretol, Carbatrol);
• lithium (Lithobid, Eskalith, others);
• theophylline (Theo-Dur, Theochron, Theolair, Theobid, Elixophyllin, Slo-Phyllin, others);
• rifampin (Rifadin, Rimactane);
• phenobarbital (Luminal, Solfoton);
• an HMG CoA reductase inhibitor such as atorvastatin (Lipitor), lovastatin (Mevacor), simvastatin (Zocor), and others; or
• another heart medication such as propranolol (Inderal), metoprolol (Lopressor, Toprol XL), atenolol (Tenormin), digoxin (Lanoxin), quinidine (Quinora, Quinidex, Quinaglute), flecainide (Tambocor), disopyramide (Norpace), captopril (Capoten), enalapril (Vasotec), and others.

You may not be able to take verapamil, or you may require a dosage adjustment or special monitoring if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with verapamil or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

Isoptin

Popularity: 9% [?]

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