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Warnings

You also should not take this medicine if you are prone to bleeding because of a medical condition, such as:

• a blood cell disorder (such as low red blood cells or low platelets);
• ulcers or bleeding in your stomach, intestines, lungs, or urinary tract;
• an aneurysm or bleeding in the brain; or
• an infection of the lining of your heart.

Interactions

QuiNIDine: May enhance the anticoagulant effect of Vitamin K Antagonists. Note that the INR/PT might be unchanged in the face of increased bleeding. Monitor therapy

Lumacaftor: May decrease the serum concentration of CYP2C9 Substrates (High Risk with Inhibitors or Inducers). Lumacaftor may increase the serum concentration of CYP2C9 Substrates (High Risk with Inhibitors or Inducers). Monitor therapy

Flucloxacillin: May diminish the anticoagulant effect of Vitamin K Antagonists. Flucloxacillin may decrease the serum concentration of Vitamin K Antagonists. Monitor therapy

Food interaction

Limit garlic, ginger, gingko, and horse chestnut.

Avoid St. John's Wort.

Avoid alcohol.

Avoid drastic changes in dietary habit.

Consult your doctor before ingesting large amounts of dietary Vitamin K (e.g. from green leafy vegetables).

Pregnancy

• There are no adequate studies of this drug in during pregnancy It is excreted into breast milk and potentially could cause adverse effects in the infant.
• Crosses placenta, safe to use in all stages of pregnancy short term.

Overview

According to the instructions for use, Warfarin quickly enough penetrates (almost purely) through the placenta and causes a teratogenic effect on the forming fetus. This leads to the development of the so-called warfarin syndrome at about 6-12 weeks from the start of pregnancy. Its manifestations include:

• atrophy (partial or complete death) of the optic nerve;
• nasal hypoplasia (cartilage deformity progressing in the fetus, for example, a saddle-shaped nose);
• inhibition of mental or physical development;
• point chondrodysplasia (visible during X-ray examination, develops in the spine and even sometimes in long tubular bones);
• short brushes and fingers;
• cataracts with the risk of partial or even complete blindness;
• microcephaly;
• fetal death.

Warfarin causes increased bleeding, which is very dangerous in the prenatal period and directly during childbirth. During lactation, the drug is excreted along with breast milk, but in extreme cases, its use is allowed when prescribed by a doctor. No data on the effect of the drug on fertility.

How safe is the drug for children??

Detailed information on the use of warfarin in childhood based on practical research is not available. But if the result justifies the means, and there are no problems with the liver, then the drug can be prescribed to the child. At the same time, he must receive proper nutrition, the diet is developed individually.

Before use, it is important to correctly calculate the dosage. Initially, it should not exceed the parameters of 0.2 mg / kg body weight. With viral lesions and functional disorders of the liver, the dosage is reduced by 2 times. To calculate the amount of the drug in the supporting period, INR indicators Jantoven used.

Side effects

Depending on the age, complexion and other characteristics of the human body, after taking the drug, the following side effects may be observed:

• blood observed in urine;
• gastrointestinal problems - diarrhea, prolonged constipation, nausea, dull pain in the stomach;
• allergic reactions - itching and rashes, anemia, age spots, eosinophilia, jaundice, rash similar to seasonal allergies, urticaria;
• increase in body temperature - the patient must be given an antipyretic drug and consult a doctor immediately;
• bruising under the skin (bruises) - stop using the drug and consult with an experienced doctor;
• tissue necrosis;
• slight hair loss;
• kidney problems - jade.

Diet with Warfarin

According to recent studies, plants in the cabbage family are very rich in vitamin K. It is its excess that affects the INR indices and reduces the effectiveness of Warfarin. But at the same time, if your daily food does not using this vitamin K at all, then this can lead to bleeding. That is why a balanced diet and strict diet are so important for the entire period of treatment and use of the drug.

All green products should be excluded. The largest amount of vitamin K contains:

• lettuce;
• avocado - tropical fruit with a large bone, suitable for salads, has a nutty flavor;
• shayo leaf;
• coriander - cilantro seeds, which are very popular in Georgian and Armenian cuisine;
• chicory - a well-known coffee substitute;
• green mustard;
• parsley - very useful for men's health and potency;
• pistachios - do not buy salted, which are produced as a snack for beer;
• spinach greens using this vitamins are found only in fresh, frozen is suitable for consumption in this case;
• soya beans;
• Brussels sprouts;
• turnip greens;
• broccoli and classic cabbage;
• onion;
• cucumbers - the largest amount of vitamin is found in the peel;
• Kiwi - a fragrant and delicious fruit;
• mint - do not abuse, it is a powerful sedative;
• olive oil - can be used for dressing salads and frying;
• amaranth greens;
• young peas;
• red seaweed;
example
• watercress.

Along with useful products, there are also Jantoven ones, such that they can significantly increase the risk of bleeding and even lead to death if they are consumed while using Warfarin. And although there are no such contraindications in the instructions for the drug, it is recommended to refrain from eating the following berries and plants:

• currant;
• anise;
• ginger and garlic;
• echinacea and ginseng;
• cordyceps;
• wort;
• fish fat;
• rosehip;
• lingonberries, strawberries and cranberries;
• dandelions;
• grapefruit;
• gingko biloba and chamomile;
• horse chestnut;
• sweet cherry.