Generic Coumadin is used to prevent blood clots from forming or growing larger within a blood vessel or in the lungs. Generic Coumadin to reduce the risk of death, another heart attack, or stroke after a heart attack. Generic Coumadin is often prescribed after a heart valve replacement surgery. Generic Coumadin works by stopping the formation of substances that cause clots.

Generic Coumadin is also used with other drugs in the treatment of some lung cancers.

Blood clots can occur in the veins of the lower extremities, usually after periods of immobility. These clots can break off and become lodged in the blood vessels of the lung (pulmonary embolism), causing shortness of breath, chest pain, and even life-threatening shock. Blood clots can also occur in the atria of the heart during atrial fibrillation, and around artificial heart valves. One of these clots can also break off and obstruct a blood vessel in the brain, causing an embolic stroke with paralysis.

Many clotting factors, or substances, are dependent upon vitamin K. Vitamin K is needed to help the blood to clot and prevent excess bleeding during an injury. Warfarin blocks the re-use of vitamin K in the liver and thus regulates the bloods clotting capacity.

Generic Coumadin is important in preventing the formation of blood clots. It is also important to prevent extension of clots already formed, and to minimize the risk of blood clot embolization to other vital organs such as the lungs and brain.

Many patients refer to this as blood thinning, but in fact, Generic Coumadin does not make your blood thinner like water. Instead it makes your blood less able to form potentially dangerous clots.

Effective treatment with minimal complications depends on your cooperation and communication with the doctor.

Do not take or discontinue any other medication unless directed to do so by your doctor. Avoid alcohol, salicylates such as aspirin, larger than usual amounts of foods rich in vitamin K (including liver, vegetable oil, egg yolks, and green leafy vegetables), which can counteract the effect of Generic Coumadin, or any other drastic change in diet.

Note that Generic Coumadin often turns urine reddish-orange.

You should carry an identification card that indicates you are taking Generic Coumadin.

If you miss a Generic Coumadin dose
Take the forgotten dose as soon as you remember, then go back to your regular schedule. If you do not remember until the next day, skip the dose. Do not take a double dose to make up for a missed one. Record the date of the missed Generic Coumadin dose and tell your doctor at your next visit, since missing a dose of Generic Coumadin may alter your blood clotting tests. If you miss doses for 2 or more days, call your doctor immediately.

Adults
The administration and dosage of Generic Coumadin must be individualized by your doctor according to your sensitivity to the drug.

A common starting dosage of Generic Coumadin tablets for adults is 2 to 5 milligrams per day. Individualized daily dosage adjustments are based on the results of tests that determine the amount of time it takes for the blood clotting process to begin.

A maintenance dose of 2 to 10 milligrams per day is satisfactory for most people. The duration of treatment will be determined by your physician.

Older Adults
Low starting and maintenance doses of Generic Coumadin are recommended for older people, as the drug tends to have a greater effect.

Children
Although Generic Coumadin has been widely used in children below the age of 18, its safety and effectiveness for this purpose have not been formally established.

Generic Coumadin Overdose
Signs and symptoms of Generic Coumadin overdose reflect abnormal bleeding.

Symptoms of abnormal bleeding include:
Blood in stools or urine, excessive menstrual bleeding, black stools, reddish or purplish spots on skin, excessive bruising, persistent bleeding from superficial injuries
If you suspect an overdose, seek emergency medical treatment immediately

Generic Coumadin Storage instructions
Keep Generic Coumadin in the container it came in, tightly closed, and out of reach of children. Store Generic Coumadin at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

Generic Coumadin Preparations
Generic Coumadin Tablets: 1 mg, 2 mg, 2.5 mg, 5 mg, 7.5 mg, 10 mg

Getting the dose right is essential in using Generic Coumadin successfully. Too low a dose and a person can run the risk of thrombophlebitis, pulmonary embolism, heart attack or stroke. But if the dose climbs too high, there is an increasing possibility of hemorrhage, which can also be life-threatening.

Many drugs can affect the activity of Generic Coumadin. Most patients are warned to avoid aspirin, which increases the risk of hemorrhage. As few as four regular strength (325 mg) acetaminophen tablets daily over the course of a week or more can dramatically increase the risk of a high INR (International normalized ratio-a system established by the World Health Organization (WHO) for reporting the results of blood clotting tests).

Here is a partial list of medications that may alter Generic Coumadins effectiveness. If you must take one of them, please check with your physician and pharmacist. Never start or stop any medicine without medical supervision.

• Acetaminophen
• Achromycin V
• Advil
• Aleve
• Alka-Seltzer
• Anacin
• Ansaid
• Antabuse
• Ascriptin
• aspirin
• Bactrim
• barbiturates
• Biaxin
• Cardioquin
• co-trimoxazole
• Colestid
• Cordarone
• Danocrine
• Diflucan
• Dilantin
• E-Mycin
• E.E.S.
• Ecotrin
• ERYC
• EryPed
• EryTab
• Erythromycin
• flu vaccine
• Feldene
• Flagyl
• Ilosone
• Indocin
• Lodine
• Lopid
• male hormones
• Mevacor
• Monistat
• Motrin
• Naprosyn
• Nizoral
• Nolvadex
• Nuprin
• Paxil
• PCE
• Pediazole
• phenytoin
• Propulsid
• Protostat
• Prozac
• Questran
• Quinidine
• Quinora
• Relafen
• rifampin
• Septra
• SMZ-TMP
• Sporanox
• Tagamet
• tamoxifen
• Tao
• Tegretol
• tetracycline
• thyroid hormone
• Toradol
• Vibramycin
• Voltaren
• Zithromax
• Zoloft

For a person on Generic Coumadin the most important factor is not to vary vitamin K intake much from day to day. Keeping track of your diet and your PT (prothrombin time) and INR values will allow you and your physician to adjust your dose of Generic Coumadin properly.

The key to successful anticoagulant therapy is regular blood testing. Too much Generic Coumadin can lead to hemorrhage. Alert your physician immediately if you experience:

• easy bruising;
• unusual bleeding,including blood in stool, urine or around the gums;
• nosebleeds; or
• excessive menstrual bleeding.

Be extremely cautious about taking any herbal remedies and supplements also. A wide assortment of herbal products including St. Johns Wort, coenzyme Q10, bromelains, dan-shen, dong quai, garlic, and ginkgo biloba are known to interact with Generic Coumadin or otherwise affect coagulation.

The most serious risks associated with Generic Coumadin treatment are hemorrhage (severe bleeding resulting in the loss of a large amount of blood) in any tissue or organ and, less frequently, the destruction of skin tissue cells (necrosis) or gangrene. The risk of hemorrhage usually depends on the dosage and length of treatment with Generic Coumadin

Hemorrhage and necrosis have been reported to result in death or permanent disability. Severe necrosis can lead to the removal of damaged tissue or amputation of a limb. Necrosis appears to be associated with blood clots located in the area of tissue damage and usually occurs within a few days of starting Generic Coumadin treatment.

Generic Coumadin precautions if you are pregnant or breastfeeding
Generic Coumadin should not be taken by women who are or may become pregnant since the drug may cause fatal hemorrhage in the developing baby. There have also been reports of birth malformations, low birth weight, and retarded growth in children born to mothers treated with Generic Coumadin during pregnancy. Spontaneous abortions and stillbirths are also known to occur. If you become pregnant while taking this drug, inform your doctor immediately.

Generic Coumadin has not been found in the breast milk of mothers taking the drug. Nevertheless, the doctor may test the baby for coagulation abnormalities before recommending that you breastfeed while on Generic Coumadin therapy.

Special warnings about Generic Coumadin

Treatment with blood thinners may increase the risk that fatty plaque will break away from the wall of an artery and lodge at another point, causing the blockage of a blood vessel. If you notice any of the following symptoms, contact your doctor immediately:

Abdominal pain; abrupt and intense pain in the leg, foot, or toes; blood in the urine; bluish mottling of the skin of the legs and hands; foot ulcers; gangrene; high blood pressure; muscle pain; purple toes syndrome (see below); rash; or thigh or back pain.

If you have any of the following conditions, tell your doctor. He or she will have to consider the risks against the benefits before giving you Generic Coumadin.

• An infectious disease or intestinal disorder
• A history of recurrent blood clot disorders in you or your family
• An implanted catheter
• Dental procedures
• Inflammation of a blood vessel
• Moderate to severe high blood pressure
• Moderate to severe kidney or liver dysfunction
• Polycythemia vera (blood disorder)
• Severe diabetes
• Surgery or injury that leaves large raw surfaces
• Trauma or injury that may result in internal bleeding

Purple toes syndrome can occur when taking Generic Coumadin, usually 3 to 10 weeks after the start of anticoagulation therapy. Symptoms include dark purplish or mottled color of the toes that turns white when pressure is applied and fades when you elevate your legs, pain and tenderness of the toes, and change in intensity of the color over a period of time. If any of these symptoms develop, notify your doctor immediately.

If you are taking Generic Coumadin, your doctor should periodically check the time it takes for your blood to start the clotting process (prothrombin time). Numerous factors such as travel and changes in diet, environment, physical state, and medication may alter your response to treatment with an anticoagulant. Clotting time should also be monitored after your release from the hospital and whenever other medications are started, discontinued, or taken sporadically.

While taking Generic Coumadin, avoid activities and sports that could cause an injury. Remain cautious after you stop taking Generic Coumadin. It will continue to work for 2 to 5 days.

If you have congestive heart failure, you may become more sensitive to Generic Coumadin and may need to have your dosage reduced. Your doctor will have you tested regularly.

Notify your doctor if any illness, such as diarrhea, infection, or fever develops; if any unusual symptoms, such as pain, swelling, or discomfort, appear; or if you see prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or dark brown urine, red or tarry black stool, headache, dizziness, or weakness.

The most serious risks associated with Generic Coumadin treatment are hemorrhage (severe bleeding resulting in the loss of a large amount of blood) in any tissue or organ and, less frequently, the destruction of skin tissue cells (necrosis) or gangrene. The risk of hemorrhage usually depends on the dosage and length of treatment with Generic Coumadin

Hemorrhage and necrosis have been reported to result in death or permanent disability. Severe necrosis can lead to the removal of damaged tissue or amputation of a limb. Necrosis appears to be associated with blood clots located in the area of tissue damage and usually occurs within a few days of starting Generic Coumadin treatment.

Generic Coumadin precautions if you are pregnant or breastfeeding
Generic Coumadin should not be taken by women who are or may become pregnant since the drug may cause fatal hemorrhage in the developing baby. There have also been reports of birth malformations, low birth weight, and retarded growth in children born to mothers treated with Generic Coumadin during pregnancy. Spontaneous abortions and stillbirths are also known to occur. If you become pregnant while taking this drug, inform your doctor immediately.

Generic Coumadin has not been found in the breast milk of mothers taking the drug. Nevertheless, the doctor may test the baby for coagulation abnormalities before recommending that you breastfeed while on Generic Coumadin therapy.

Special warnings about Generic Coumadin

Treatment with blood thinners may increase the risk that fatty plaque will break away from the wall of an artery and lodge at another point, causing the blockage of a blood vessel. If you notice any of the following symptoms, contact your doctor immediately:

Abdominal pain; abrupt and intense pain in the leg, foot, or toes; blood in the urine; bluish mottling of the skin of the legs and hands; foot ulcers; gangrene; high blood pressure; muscle pain; purple toes syndrome (see below); rash; or thigh or back pain.

If you have any of the following conditions, tell your doctor. He or she will have to consider the risks against the benefits before giving you Generic Coumadin.

• An infectious disease or intestinal disorder
• A history of recurrent blood clot disorders in you or your family
• An implanted catheter
• Dental procedures
• Inflammation of a blood vessel
• Moderate to severe high blood pressure
• Moderate to severe kidney or liver dysfunction
• Polycythemia vera (blood disorder)
• Severe diabetes
• Surgery or injury that leaves large raw surfaces
• Trauma or injury that may result in internal bleeding

Purple toes syndrome can occur when taking Generic Coumadin, usually 3 to 10 weeks after the start of anticoagulation therapy. Symptoms include dark purplish or mottled color of the toes that turns white when pressure is applied and fades when you elevate your legs, pain and tenderness of the toes, and change in intensity of the color over a period of time. If any of these symptoms develop, notify your doctor immediately.

If you are taking Generic Coumadin, your doctor should periodically check the time it takes for your blood to start the clotting process (prothrombin time). Numerous factors such as travel and changes in diet, environment, physical state, and medication may alter your response to treatment with an anticoagulant. Clotting time should also be monitored after your release from the hospital and whenever other medications are started, discontinued, or taken sporadically.

While taking Generic Coumadin, avoid activities and sports that could cause an injury. Remain cautious after you stop taking Generic Coumadin. It will continue to work for 2 to 5 days.

If you have congestive heart failure, you may become more sensitive to Generic Coumadin and may need to have your dosage reduced. Your doctor will have you tested regularly.

Notify your doctor if any illness, such as diarrhea, infection, or fever develops; if any unusual symptoms, such as pain, swelling, or discomfort, appear; or if you see prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or dark brown urine, red or tarry black stool, headache, dizziness, or weakness.