Page 52 - PBA Medicine list - edition 5_SW_Neat

By Dana Al Madi

Generic Name: Warfarin sodium

Brand names: Coumadin

Side effects/precautions:
Excessive GI bleeding and irritation, Haemorrhagic and necrosis risks, may enhance the release of
atheromatous plaque emboli, Calciphylaxis: Calciphylaxis is a rare syndrome of vascular calcification
with cutaneous necrosis. Use in elderly with polypharmacy should be monitored for adverse reactions.

Interactions:

Streptokinase, urokinase (not recommended); CYP2C9, 1A2, 3A4 inhibitors, inducers;
hypoglycaemics; anticonvulsants; antiplatelets; drugs affecting INR/PT response incl heparin, incr
bleeding risk incl SSRIs; NSAIDs incl aspirin; direct acting HCV antivirals; antiarrhythmics;
paracetamol; antimicrobials; immunosuppressives, antineoplastics; barbiturates; OCs; androgens;
levothyroxine; allopurinol; vit/ herbal preps incl St John's wort; alcohol; others (many).

Reasons for interactions:
Increased protein binding to albumin which increases the chance for the effects of GI bleeding

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