Warfarin 2.5 mg canon 100 pcs tab

$2.38

Warfarin 2.5 mg canon 100 pcs tab

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Description

Composition
Active substance:
1 tablet contains 2.5 mg of warfarin sodium ;.
Excipients:
Calcium hydrogen phosphate dihydrate 65.5 mg microcrystalline cellulose 60 mg Colloidal silicon dioxide 1 mg, 6 mg copovidone, croscarmellose sodium 4 mg Magnesium stearate 1 mg.
Description:
Tablets white or white color with a yellowish shade, with a biconcave cruciform mark.
Product form:
Tablets of 2.50 mg. 10, 20 or 30 tablets in blisters of PVC film and aluminum foil printed patent.
3, 5, 10 contour cell packs of 10 tablets or contour of cellular packages 5 to 20 tablets, 1, 2, 3, 4, 5 contour cell packs of 30 tablets together with instructions for use placed in a pile of cardboard.
Contraindications
Hypersensitivity, acute bleeding, severe liver disease or kidney disease, severe hypertension, acute DIC, deficiency of protein C and S, hemorrhagic diathesis, thrombocytopenia, peptic ulcer and duodenum 12 in the acute stage, cerebral hemorrhage, alcoholism, renal failure, pregnancy.
Use during pregnancy and lactation
The drug should not be administered to pregnant women in connection with the revealed teratogenic action of bleeding in the fetus and fetal death. Warfarin is excreted in breast milk in small quantities and almost no effect on blood clotting in the child, so the drug can be used during lactation, but it is desirable to refrain from breast-feeding in the first 3 days of warfarin therapy.
Indications
Treatment and prevention of vascular thrombosis and thromboembolism, acute venous thrombosis and pulmonary embolism; postoperative thrombosis; recurrent myocardial infarction; as a supplementary drug (PM) during a surgical or thrombolytic treatment of thrombosis, as well as electrical cardioversion of atrial fibrillation; recurrent venous thrombosis; repeated pulmonary embolism; prosthetic heart valves and blood vessels (possible combination with acetylsalicylic acid (ASA), peripheral thrombosis, coronary and cerebral arteries, secondary prevention of thrombosis and embolism after myocardial infarction, atrial fibrillation.
Interaction with other drugs
Nonsteroidal anti-inflammatory drugs (NSAIDs), dipyridamole, valproic acid, inhibitors of cytochrome P450 (cimetidine, chloramphenicol) increase the risk of bleeding. Avoid combined use of these drugs and warfarin (cimetidine can be replaced with ranitidine or famotidine). If necessary, treatment with chloramphenicol anticoagulant therapy should be temporarily discontinued. Diuretics can reduce anticoagulant effect (expressed in the case of hypovolemic action, which may lead to an increase in the concentration of blood clotting factors).
Weaken the effect of: barbiturates, vitamin K, glutethimide, griseofulvin, dicloxacillin, carbamazepine, mianserin, paracetamol, retinoids, rifampicin, sucralfate, phenazone, cholestyramine.
Heighten: allopurinol, amiodarone, anabolic steroids (alkylated at C17 position), ASA and other NSAIDs, heparin, glibenclamide, glucagon, danazol, diazoxide, disopyramide, disulfiram, isoniazid, ketoconazole, clarithromycin, clofibrate, levamisole, metronidazole, miconazole, nalidixic acid , nilutamide, omeprazole, paroxetine, proguanil, oral hypoglycemic drugs – sulfonamides derivatives, simvastatin, sulfonamides, tamoxifen, thyroxine, quinine, quinidine, fluvoxamine, fluconazole, fluorouracil, quinolones, chloral hydrate, hloramfeni ol, cephalosporins, cimetidine, erythromycin, ethacrynic acid, ethanol. In the case of combined use of warfarin with the above drugs should be carried out MHO control at the beginning and end of treatment and whenever possible within 2-3 weeks of therapy.
When using a LAN (e.g., laxatives, drugs) that can increase the risk of bleeding due to reduced normal coagulation (inhibition of coagulation factors or liver enzymes), anticoagulant therapy strategy should be determined by the possibility of the laboratory control. If possible frequent laboratory control, the need for therapy at similar drug warfarin dose can be reduced by 5-10%. If the conduct of laboratory monitoring is difficult, then, if necessary, the appointment of these drugs should be discontinued warfarin.
Overdose
Symptoms: bleeding, bleeding. Treatment: if the prothrombin time is more than 5% and there are no other possible sources of bleeding (nefrourolitiaz et al.), The correction is not required dosing regime. When minor bleeding is necessary to reduce the dose or stop treatment for a short time. In the case of severe bleeding – vitamin K to recover coagulant activity. When threatening bleeding – transfusion prothrombin complex concentrates or fresh frozen plasma, or whole blood.
pharmachologic effect
Pharmacological group:
Anticoagulant means of indirect action.
Pharmacodynamics:
Indirect anticoagulants. Inhibits hepatic synthesis of Vitamin K dependent coagulation factors (II, VII, IX and X), and protein C and S in the liver. Optimal anticoagulant effect is observed on 3-5 day from the beginning of the application and ends in 3-5 days after the last dose.
Pharmacokinetics:
After oral warfarin completely absorbed in the gastrointestinal tract (GIT). Communication with plasma proteins – 97-99%. Therapeutic plasma concentration – 5.1 mg / ml (0.003-0.015 mmol / l). It is in the form of racemic compound, wherein in the human L-isomer is more active than the dextrorotatory. It crosses the placenta, but not secreted in breast milk.
The drug is metabolized in the liver to inactive and weakly active metabolites that are reabsorbed from the bile, the L-isomer is metabolized faster. The half-life of racemic warfarin -. 40 hours excreted by the kidneys.
Conditions of supply of pharmacies
On prescription.
side effects
Most often – bleeding. Rarely – diarrhea, increased activity of “liver” enzymes, eczema, skin necrosis; vasculitis, hair loss.
special instructions
Before therapy parameter determined INR (or prothrombin time based thromboplastin sensitivity coefficient). In the future hold regular (every 2-4-8 weeks) laboratory testing.
During the period of treatment should refrain from the use of ethanol (risk of hypoprothrombinemia and bleeding).
Storage conditions
In a dry, dark place at a temperature not higher than 25 ° C.
Keep out of the reach of children.
Dosing and Administration
Inside, at one time, at one and the same time of day.
Starting dose – 2.5-5 mg / day. Further dosing regimen set individually depending on the results of the determination of the prothrombin time and international normalized ratio (MHO). Prothrombin time should be increased by 2-4 fold from the original, and should achieve an INR 2.2-4.4 depending on the disease, thrombosis hazards, risk of bleeding and the individual characteristics of the patient.
In determining the INR should take into account the sensitivity of the index thromboplastin and may use it as a correction factor (1.22 – using domestic thromboplastin from rabbit “Neoplast” brain and 1.2-thromboplastin using the company “Roche Diagnostics”).
Elderly or debilitated patients are usually prescribed a lower dose.
Before the upcoming surgery (at high risk of thromboembolic complications), treatment is initiated 2-3 days before surgery.
In the case of acute thrombosis treatment is carried out in combination with heparin until yet not fully manifest the effect of oral anticoagulant therapy (no earlier than 3-5 days of treatment).
In prosthetic heart valves, veins acute venous thrombosis or embolism (in the early stages), left ventricular thrombosis and for the prevention of myocardial ischemia need to strive for effective action noted in INR – 2.8-4.0.
In the case of atrial fibrillation and during the maintenance therapy of thrombosis and venous thromboembolism achieve moderate anticoagulant effect (INR 2-3). When combined with warfarin INR ACK indicator must be in the range 2-2.5.
The duration of treatment depends on the patient’s condition. Treatment can be canceled immediately.
Information
Appearance may differ from that depicted in the picture. There are contraindications. You need to read the manual or consult with a specialist

Additional information

Weight0.100 kg
Manufacturer

KANONFARMA

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