BEERS REMS, High Alert
Contraindicated in:
Use Cautiously in:
Drug-drug:
Drug-Natural Products:
Drug-Food:
Ingestion of large quantities of foods high in vitamin K content (see list in Food Sources for Specific Nutrients) may antagonize the anticoagulant effect of warfarin.
Absorption: Well absorbed from the GI tract after oral administration.
Distribution: Minimally distributed to tissues.
Protein Binding: 99%.
Half-Life: 42 hr.
Review foods high in vitamin K (see Food Sources for Specific Nutrients). Patient should have consistent limited intake of these foods, as vitamin K is the antidote for warfarin, and alternating intake of these foods will cause coagulation to fluctuate. Advise patient to avoid cranberry juice or products during therapy.
Caution patient to avoid IM injections and activities leading to injury. Instruct patient to use a soft toothbrush, not to floss, and to shave with an electric razor during warfarin therapy. Advise patient that venipunctures and injection sites require application of pressure to prevent bleeding or hematoma formation.
Advise patient to notify health care provider of unusual bleeding or bruising (bleeding gums; nosebleed; black, tarry stools; hematuria; excessive menstrual flow) and pain, color, or temperature change to any area of the body.
Notify patient with deficiency in protein C and/or S mediated anticoagulant response that they may be at ↑ risk for tissue necrosis.NDC Code
