Coumadin is an anticoagulant (blood thinner).
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 Coumadin treatment.
The most serious risks associated with 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 this drug.
It is prescribed to:
- Aid in the prevention of blood clots that may form in blood vessels anywhere in the body after a heart attack;
- Prevent and/or treat a blood clot that has formed within a blood vessel or in the lungs;
- Prevent and/or treat blood clots associated with certain heart conditions or replacement of a heart valve;
- Reduce the risk of death, another heart attack, or stroke after a heart attack;
Coumadin side effects that you should report to your health care professional or doctor as soon as possible:
More common side effects may include:
Hemorrhage: Signs of severe bleeding resulting in the loss of large amounts of blood depend upon the location and extent of bleeding.
- Unexplained swelling;
- Unexplained shock;
- Shortness of breath;
- Numbness and tingling;
- Low blood pressure;
- Difficult breathing or swallowing;
- Chest abdomen joint muscle or other pain;
Less common side effects may include:
- Yellowed skin and eyes;
- Taste changes;
- Severe or long-lasting inflammation of the skin;
- Purple toes;
- Necrosis (gangrene);
- Loss of hair;
- Liver damage;
- Intolerance to cold;
- Gas and bloating;
- Fluid retention and swelling;
- Feeling of illness;
- Feeling cold and chills;
- Allergic reactions;
- Abdominal pain and cramping;
Coumadin is contraindicated if you have any of the following conditions:
- If you have a history of recurrent blood clot disorders in you or your family;
- If you have a tendency to hemorrhage;
- If you have alcoholism;
- If you have allergy to any of the drug's ingredients;
- If you have an abnormal blood condition;
- If you have an implanted catheter;
- If you have an infectious disease or intestinal disorder;
- If you have aneurysm (balloon-like swelling of a blood vessel) in the brain or heart;
- If you have bleeding tendencies associated with: ulceration or bleeding of the stomach, intestines, respiratory tract, or the genital or urinary system;
- If you have dental procedures;
- If you have eclampsia (a rare and serious pregnancy disorder producing life-threatening convulsions), or preeclampsia (a toxic condition--including headache, high blood pressure, and swelling of the legs and feet--that can lead to eclampsia);
- If you have excessive bleeding of brain blood vessels;
- If you have inflammation of a blood vessel;
- If you have inflammation of the sac that surrounds the heart or an escape of fluid from the heart sac;
- If you have inflammation, due to bacterial infection, of the membrane that lines the inside of the heart;
- If you have malignant hypertension (extremely elevated blood pressure that damages the inner linings of blood vessels, the heart, spleen, kidneys, and brain);
- If you have moderate to severe high blood pressure;
- If you have moderate to severe kidney or liver dysfunction;
- If you have polycythemia vera (blood disorder);
- If you have pregnancy;
- If you have recent or contemplated surgery of the central nervous system (brain and spinal cord) or eye;
- If you have severe diabetes;
- If you have spinal puncture or any procedure that can cause uncontrollable bleeding;
- If you have surgery or injury that leaves large raw surfaces;
- If you have threatened miscarriage;
- If you have trauma or injury that may result in internal bleeding;
Do not take Coumadin with any of the following drugs:
- A wide assortment of herbal products--including st. john's wort, coenzyme q10, bromelains, dan-shen, dong quai, garlic, and ginkgo biloba--are known to interact with coumadin or otherwise affect coagulation;
- Be extremely cautious, too, about taking any herbal remedies and supplements;
- Check with your doctor before taking any other medication or vitamin product;
- Coumadin can interact with a very wide variety of drugs, both script and over-the-counter;
A common starting dosage of Coumadin tablets for adults is 2 to 5 milligrams per day.
The administration and dosage of Coumadin must be individualized by your doctor according to your sensitivity to the drug.
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.
Low starting and maintenance doses are recommended for older people, as the drug tends to have a greater effect.
Although Coumadin has been widely prescribed in children below the age of 18, its safety and effectiveness for this purpose have not been formally established.
Symptoms of abnormal bleeding include:
- Reddish or purplish spots on skin;
- Persistent bleeding from superficial injuries;
- Excessive menstrual bleeding;
- Excessive bruising;
- Blood in stools or urine;
- Black stools;