What is Warfarin and how does it work?
Warfarin is a medication that helps to stop your blood clotting too quickly. It does thisby stopping the body from making too many substances that make the blood clot. Itmay be called Marevan or Coumadin. Unless directed by your doctor, it isimportant to always keep taking the brand your doctor first prescribed as Coumadinand Marevan are not exactly the same.
Why am I on this medication?
Your doctor may have prescribed Warfarin for you because you have a condition which mayincrease the risk of harmful blood clots forming in the body. These conditions include atrialfibrillation (irregular heart beat), heart valve replacements and blood clots in the legs or thelungs. Warfarin reduces your risk of clots forming by slowing down the clotting of yourblood.
How much Warfarin do I take and when do I take it?
Your doctor will tell you what dose of Warfarin to take each day. You need to take Warfarinat the same time each day as directed by your doctor. You can take it with OR without food.
Do not stop taking your Warfarin unless you have been advised to do so by your doctor.
What happens if I accidentally miss a dose of Warfarin?
If you remember within 2-3 hours of the appropriate time, you can still take your
medication. If not, take your next dose at the normal time the next day and tell your doctor.
DO NOT TAKE A DOUBLE DOSE.
Do I need to be monitored?
Your INR (International Normalised Ratio) has to be measured at regular intervals as decidedby your Doctor. The INR is a measure of how quickly your blood clots. If the INR is too high,your blood is taking a long time to clot. If the INR is too low, your blood is clotting tooquickly.
Your doctor will be tell you what range your INR should stay between. Your doctor will
adjust your Warfarin dose as needed to prevent the formation of clots and to avoidexcessive bleeding.
Are there any risks?
Because Warfarin slows down the clotting of your blood, it can cause bleeding. You mightfind you have small nose bleeds, bleeding gums, extra bruises on your skin, or notice that ifyou cut yourself it takes a long time to clot.
If the INR gets too high, there is a risk of more severe bleeding. Talk to your doctor aboutwhat symptoms to look out for and what to do if this occurs.
Can any foods or medications affect the way my Warfarin works?
Foods containing Vitamin K can alter INR readings. Vitamin K is present in many common
foods, such as vegetables and fruit. Foods with the highest content include leafy green
vegetables such as spinach, kale, broccoli and brussell sprouts. Onions, herbs (e.g. parsley),
spices and animal liver also contain Vitamin K.
Unless your doctor tells you to, you do not have to stop eating leafy green vegetables and
other foods containing Vitamin K. It is important that you have a balanced and consistent
healthy diet. Talk to your doctor if there are any major changes to your diet and lifestyle.
Check with your doctor before starting any new medications or any herbal/alternative
supplements from the pharmacy or health food shop. Some medications may decrease your
INR and others may increase it.
Drinking too much alcohol can increase your INR, making your blood take a long time to clot.
This could lead to a bleeding event. Discuss alcohol consumption with your doctor.
What do I do if I need to have surgery or a special procedure?
Warfarin may need to be stopped temporarily for a particular surgery or procedure. Talk toyour doctor to see if this is applicable to you.
Who do I speak to if I have any questions?
Talk to your doctor if you have any questions or concerns about taking Warfarin.
UMORE 2008, The Unit for Medications Research Outcomes and Education, ‘Warfarin and You - Consumer Information Leaflet ’.
www.anticoagulation.com.au Accessed 11 March 2011.
WAMSG 2007, Western Australia Medication Safety Group - Western Australia Department of Health , 'Living with Warfarin –
Information for Patients' Accessed 28 March 2011http://www.health.wa.gov.au/docreg/Education/Population/Health_Problems/HP8948_warfarin_B.pdf
Attention Deficit Hyperactivity Disorder: throughout the Lifespan Roland Rotz, Ph.D. AD/HD…Current definition A lifespan neurobiological condition characterized by behavioral difficulties in the areas of inattention, poor impulse control, and/or hyperactivity impacting relationships and/or activities of daily living such as work or school. Presence of symptoms
Date: 20121120 Docket: T-772-09 Citation: 2012 FC 1339 Ottawa, Ontario, November 20, 2012 PRESENT: The Honourable Mr. Justice Zinn BETWEEN: APOTEX INC. Plaintiff PFIZER IRELAND PHARMACEUTICALS Defendant REASONS FOR JUDGMENT AND JUDGMENT This is an impeachment action commenced on May 13, 2009, wherein Apotex, the plaintiff, seeks a declaration tha