Do not switch brands once desired therapeutic response has been reached.
Notify your doctor if you have active tuberculosis, diabetes, protein C and S deficiency, hemorrhagic tendencies, severe uncontrolled or malignant hypertension, severe liver disease, invasive procedures with potential for bleeding, risk of falls, pregnancy, warfarin-induced necrosis, ascorbic acid deficiency.
Concurrent use with NSAIDs or aspirin may cause severe gastric irritation and increased risk of bleeding.
Warfarin should be stopped three days prior to surgical procedures and blood monitoring checked prior to procedure.
DRUG INTERACTIONS
This drug is metabolized by a specific set of liver enzymes (cytochrome P450 enzymes). Several other drugs interfere with these liver enzymes, and thus may increase or decrease the clearance of warfarin from the body, potentially increasing the risk of side effects or decreasing effectiveness.
When these drugs are given in combination with warfarin, dosage adjustments may be needed. As these are too numerous to list, you should always check with your doctor or pharmacist prior to starting a new medication, herbal, or non-prescription product.
FOOD INTERACTIONS
Avoid or decrease quantities ingested of foods rich in vitamin K, vitamin E, cranberry juice
HERBAL INTERACTIONS
St. John’s wort, alfalfa, coenzyme Q10, cat’s claw, dong quai, bromelains, evening primrose, feverfew, red clover, horse chestnut, garlic, green tea, ginseng, ginkgo, avocado, boldo
PREGNANCY AND BREAST-FEEDING CAUTIONS
FDA Pregnancy Risk Category X. Do not take while pregnant. Consult your doctor regarding breast-feeding.
SPECIAL INFORMATION
It is important to not change dietary consumption of vitamin K once stabilized on warfarin therapy. Foods which contain vitamin K include, but are not limited to: beef liver, pork liver, green tea, leafy green vegetables.
