Warfarin Sodium


The commercial form of Warfarin Sodium is a mixture of R (dextrorotatory) and S (levorotatory) enantiomers. Coumadin is used for the treatment of pulmonary embolism and venous thrombosis. Coumadin acts as competitive antagonists of vitamin K and reduce the levels of functional clotting factors in a dose dependent manner. Coumadin interferes with regeneration of the active hydroquinone form of vitamin K, which carries out final step of carboxylating glutamate residues of prothrombin and clotting factors. This carboxylation step is required for clotting factors to bind with calcium and get a phospholipid surface that is necessary for coagulation process.

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How does Warfarin Sodium / Generic of Coumadin

Warfarin interferes with vitamin K dependent clotting factor synthesis  in liver by inhibition of the C1 subunit of the vitamin K epoxide reductase (VKORC1) enzyme complex.  Thus  Warfarin reduces the regeneration of vitamin K1 epoxide.

Side effects of Warfarin Sodium / Generic of Couma

The common side effects reported with Coumadin are paresthesia, headache, chest, abdomen, joint, dizziness, shortness of breath, difficult breathing or swallowing, unexplained swelling, weakness, hypotension, unexplained shock necrosis of skin and other tissues,  hypersensitivity/allergic reactions, anaphylactic reactions,  fever, rash, and dermatitis.

Guidelines before using Warfarin Sodium

The dose of Warfarin sodium should be reduced in elderly and debilitated patients. The concomitant administration of  this and herbal medicines or salicylates (eg, aspirin and topical analgesics) should be avoided. Coumadin should not be given along with hypoglycemic agents (chlorpropamide and tolbutamide) and anticonvulsants (phenytoin and phenobarbital). It is contraindicated in patients with increased risk of bleeding, as it is a narrow therapeutic index drug. This is not administered in patients with real disease, cerebrovascular disease and gastrointestinal bleeding. The patient should be advised to regularly check prothrombin time. Coumadin should not be given to pregnant women.  Avoid alcohol and any activity that may result in traumatic injury. The patient should be advised to take a normal balanced diet containing vitamin K. The patient should avoid intake of canberry juice or any other canberry products. This is not recommended in pediatric patients. The concomitant use of Warfarin Sodium and nonsteroidal anti-inflammatory drugs (NSAIDs such as ibuprofen, naproxen, celecoxib) can increase the risk of bleeding.

What are the common dosages of Warfarin Sodium

The recommended starting dosage of Coumadin is 2 to 10 mg daily.

Additional Information


1mg, 2mg, 5mg


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