Drug Monograph

Warfarin
Generic name: Warfarin

Brand Names: Coumadin®

Pharmacological category: Anticoagulant

Indications/ uses: Prophylaxis and treatment of venous thrombosis, pulmonary embolism and
thromboembolic disorders; atrial fibrillation with risk of embolism and as an adjunct in the prophylaxis of
systemic embolism after myocardial infarction

Mechanism of action: Interferes with hepatic synthesis of vitamin K-dependent coagulation factors (II, VII,
IX, X)

Adverse reactions:

 Cardiovascular: Vasculitis, edema, hemorrhagic shock

 Central nervous system: Fever, lethargy, malaise, asthenia, pain, headache, dizziness, stroke
 Dermatologic: Rash, dermatitis, alopecia
 Gastrointestinal: Anorexia, nausea, vomiting, stomach cramps, abdominal pain, diarrhea, flatulence,
gastrointestinal bleeding, mouth ulcers
 Genitourinary: hematuria
 Hematologic: Hemorrhage, leukopenia, unrecognized bleeding sites
 Neuromuscular & skeletal: Paresthesia, osteoporosis

Warnings/precautions: Cautious use in severe renal disease, Hemorrhage is the most serious risk. Women
may be at risk of developing ovarian hemorrhage at the time of ovulation. Use with caution in traumas,
infection (antibiotics and fever may alter affects), renal insufficiency, prolonged dietary insufficiencies
(vitamin K deficiency), moderate-severe hypertension, , vasculitis, open wound, active TB. Use with
caution in protein C deficiency.

Pregnancy Category: D

Dose:

 Infants and Children: 0.05-0.34 mg/kg/day

 Adults: 5-15 mg/day for 2-5 days

Reference: Lexicomp