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Cholestyramine, lithium, phenytoin, probenecid, warfarin coumadin, jantoven ; an intravenous iv antibiotic medicine; any other diuretic medicine; antifungal medicine –fluconazole, voriconazole; heart or blood pressure medicine –amiodarone, candesartan, digoxin, enalapril, lisinopril, olmesartan, valsartan, and others; nsaids nonsteroidal anti-inflammatory drugs –ibuprofen advil, motrin , naproxen aleve , celecoxib, diclofenac, indomethacin, meloxicam, and others; salicylates –aspirin, nuprin backache caplet, kaopectate, kneerelief, pamprin cramp formula, pepto-bismol, tricosal, trilisate, and others or steroid medicine –oxandrolone, prednisone, and others.

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You will need frequentINRor prothrombin time teststo measure your blood-clotting time and determine your warfarin doseYou must remain under the care of a doctor while taking Coumadin.

As with most drugsat room temperatureaway from extreme coldheatlightand moisture is bestBathroom cabinets are usually NOT a good place for storing medications because of dampness.

Closely monitor INR when starting or stopping any antibiotic or antifungal in patients taking warfarin.

COUMADIN has a narrow therapeutic rangeindexand its action may be affected by factors such as other drugs and dietary vitamin KThereforeanticoagulation must be carefully monitored during COUMADIN therapyDetermine the INR daily after the administration of the initial dose until INR results stabilize in the therapeutic rangeAfter stabilizationmaintain dosing within the therapeutic range by performing periodic INRsThe frequency of performing INR should be based on the clinical situation but generally acceptable intervals for INR determinations are 1 to 4 weeksPerform additional INR tests when other warfarin products are interchanged with COUMADINas well as whenever other medications are initiateddiscontinuedor taken irregularlyHeparina common concomitant drugincreases the INRsee Conversion From Other Anticoagulants and DRUG INTERACTIONS

Bleedinge.gappearance of blood in stools or urinehematuriaexcessive menstrual bleedingmelenapetechiaeexcessive bruising or persistent oozing from superficial injuriesunexplained fall in hemoglobinis a manifestation of excessive anticoagulation.

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