Aspen Warfarin 5 mg Tablets

Indication

Prophylaxis and treatment of venous thrombosis and its extension, and of pulmonary embolism. Also indicated for the prevention of thromboembolic complications associated with atrial fibrillation and/or cardiac valve replacement.

Dosage (summary)

Initial dose typically ranges from 2 to 5 mg orally once daily, adjusted based on INR results. Maintenance doses usually range from 2 to 10 mg daily.

Onset of Action / Duration

Anticoagulant effect typically begins within 24 to 72 hours, with peak effect occurring around 5 to 7 days after initiation.

Special Populations

• Elderly patients
• Patients with hepatic impairment
• Patients with renal impairment
• Patients with malnutrition or altered nutritional status

Pregnancy & Breastfeeding

Warfarin is contraindicated in pregnancy due to risk of fetal harm. It is excreted in breast milk; caution is advised when administering to nursing mothers.

Key Drug Interactions

• Increased effect with NSAIDs, antibiotics (e.g., metronidazole, trimethoprim-sulfamethoxazole), and other anticoagulants.
• Decreased effect with certain anticonvulsants (e.g., phenytoin), rifampicin, and vitamin K.
• Food interactions with vitamin K-rich foods (e.g., green leafy vegetables) may affect INR.

Contraindications

• Active bleeding or bleeding disorders
• Severe hepatic impairment
• Recent surgery or trauma
• Pregnancy

Common side effects

• Bleeding complications (e.g., gastrointestinal, intracranial)
• Skin necrosis
• Purple toe syndrome
• Allergic reactions

Counselling Points

• Importance of regular INR monitoring and dose adjustments.
• Avoiding activities that may increase the risk of bleeding.
• Reporting any signs of bleeding or unusual bruising.
• Maintaining a consistent diet regarding vitamin K intake.