SPL MEDGUIDE

MEDICATION GUIDE

Warfarin Sodium Tablets, USP

Read this Medication Guide before you start taking warfarin sodium and each time you get a refill. There may be new information. This Medication Guide does not take the place of talking to your healthcare provider about your medical condition or treatment. You and your healthcare provider should talk about warfarin sodium when you start taking it and at regular checkups.

What is the most important information I should know about warfarin sodium?

Warfarin sodium can cause bleeding which can be serious and sometimes lead to death. This is because warfarin sodium is a blood thinner medicine that lowers the chance of blood clots forming in your body.

• You may have a higher risk of bleeding if you take warfarin sodium and:
  • are 65 years of age or older
  • have a history of stomach or intestinal bleeding
  • have high blood pressure (hypertension)
  • have a history of stroke, or "mini-stroke" (transient ischemic attack or TIA)
  • have serious heart disease
  • have a low blood count or cancer
  • have had trauma, such as an accident or surgery
  • have kidney problems
  • take other medicines that increase your risk of bleeding, including:
    • a medicine that contains heparin
    • other medicines to prevent or treat blood clots
    • nonsteroidal anti-inflammatory drugs (NSAIDs)
  • take warfarin sodium for a long time. Warfarin sodium is the active ingredient in Warfarin Sodium Tablets, USP.

Tell your healthcare provider if you take any of these medicines. Ask your healthcare provider if you are not sure if your medicine is one listed above.

Many other medicines can interact with warfarin sodium and affect the dose you need or increase warfarin sodium side effects. Do not change or stop any of your medicines or start any new medicines before you talk to your healthcare provider.

Do not take other medicines that contain warfarin sodium while taking Warfarin Sodium Tablets, USP.

• Get your regular blood test to check for your response to warfarin sodium. This blood test is called an INR test. The INR test checks to see how fast your blood clots. Your healthcare provider will decide what INR numbers are best for you. Your dose of warfarin sodium will be adjusted to keep your INR in a target range for you.
• Call your healthcare provider right away if you get any of the following signs or symptoms of bleeding problems:
  • pain, swelling, or discomfort
  • headaches, dizziness, or weakness
  • unusual bruising (bruises that develop without known cause or grow in size)
  • nosebleeds
  • bleeding gums
  • bleeding from cuts takes a long time to stop
  • menstrual bleeding or vaginal bleeding that is heavier than normal
  • pink or brown urine
  • red or black stools
  • coughing up blood
  • vomiting blood or material that looks like coffee grounds
• Some foods and beverages can interact with warfarin sodium and affect your treatment and dose.
  • Eat a normal, balanced diet. Talk to your healthcare provider before you make any diet changes. Do not eat large amounts of leafy, green vegetables. Leafy, green vegetables contain vitamin K. Certain vegetable oils also contain large amounts of vitamin K. Too much vitamin K can lower the effect of warfarin sodium.
• Always tell all of your healthcare providers that you take warfarin sodium.
• Wear or carry information that you take warfarin sodium.

See " What are the possible side effects of warfarin sodium?" for more information about side effects.

What is warfarin sodium?

Warfarin sodium is prescription medicine used to treat blood clots and to lower the chance of blood clots forming in your body. Blood clots can cause a stroke, heart attack, or other serious conditions if they form in the legs or lungs.

It is not known if warfarin sodium is safe and effective in children.

Who should not take warfarin sodium?

Do not take warfarin sodium if:

• your chance of having bleeding problems is higher than the possible benefit of treatment. Your healthcare provider will decide if warfarin sodium is right for you. Talk to your healthcare provider about all of your health conditions.
• you are pregnant unless you have a mechanical heart valve. Warfarin sodium may cause birth defects, miscarriage, or death of your unborn baby.
• you are allergic to warfarin or any of the other ingredients in Warfarin Sodium Tablets, USP. See the end of this leaflet for a complete list of ingredients in Warfarin Sodium Tablets, USP.

What should I tell my healthcare provider before taking warfarin sodium?

Before you take warfarin sodium, tell your healthcare provider if you:

• have bleeding problems
• fall often
• have liver or kidney problems
• have high blood pressure
• have a heart problem called congestive heart failure
• have diabetes
• plan to have any surgery or a dental procedure
• have any other medical conditions
• are pregnant or plan to become pregnant. See " Who should not take warfarin sodium?"
• are breast-feeding. You and your healthcare provider should decide if you will take warfarin sodium and breast-feed.

Tell all of your healthcare providers and dentists that you are taking warfarin sodium. They should talk to the healthcare provider who prescribed warfarin sodium for you before you have any surgery or dental procedure. Your warfarin sodium may need to be stopped for a short time or your may need your dose adjusted.

Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Some of your other medicines may affect the way warfarin sodium works. Certain medicines may increase your risk of bleeding. See " What is the most important information I should know about warfarin sodium?"

Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine.

How should I take warfarin sodium?

• Take warfarin sodium exactly as prescribed. Your healthcare provider will adjust your dose from time to time depending on your response to warfarin sodium.
• You must have regular blood tests and visits with your healthcare provider to monitor your condition.
• If you miss a dose of warfarin sodium, call your healthcare provider.Take the dose as soon as possible on the same day. Do not take a double dose of warfarin sodium the next day to make up for a missed dose.
• Call your healthcare provider right away if you:
  • take too much warfarin sodium
  • are sick with diarrhea, an infection, or have a fever
  • fall or injure yourself, especially if you hit your head. Your healthcare provider may need to check you

What should I avoid while taking warfarin sodium ?

• Do not do any activity or sport that may cause a serious injury.

What are the possible side effects of warfarin sodium?

Warfarin sodium may cause serious side effects including:

• See " What is the most important information I should know about warfarin sodium?"
  • Death of skin tissue (skin necrosis or gangrene). This can happen soon after starting warfarin sodium. It happens because blood clots form and block blood flow to an area of your body. Call your healthcare provider right away if you have pain, color, or temperature change to any area of your body. You may need medical care right away to prevent death or loss (amputation) of your affected body part.
  • "Purple toes syndrome." Call your healthcare provider right away if you have pain in your toes and they look purple in color or dark in color.

Tell your healthcare provider if you have any side effect that bothers you or does not go away.

These are not all of the side effects of warfarin sodium. For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

How should I store Warfarin Sodium Tablets, USP?

• Store warfarin sodium at 68°F to 77°F (20°C to 25°C).
• Keep warfarin sodium in a tightly closed container, and keep warfarin sodium out of the light.

Keep Warfarin Sodium Tablets, USP and all medicines out of the reach of children.

General information about warfarin sodium.

Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use warfarin sodium for a condition for which it was not prescribed. Do not give warfarin sodium to other people, even if they have the same symptoms that you have. It may harm them.

This Medication Guide summarizes the most important information about warfarin sodium. If you would like more information, talk with your healthcare provider. You can ask your healthcare provider or pharmacist for information about warfarin sodium that is written for healthcare professionals.

What are the ingredients in Warfarin Sodium Tablets, USP?

Active ingredient: Warfarin Sodium

Inactive ingredients: Anhydrous lactose, corn starch, and magnesium stearate

1 mg:	D&C Red No. 6 Barium Lake
2 mg:	FD&C Blue No. 2 Aluminum Lake, FD&C Red No. 40 Aluminum Lake
2.5 mg:	D&C Yellow No. 10 Aluminum Lake, FD&C Blue No. 2 Aluminum Lake
3 mg:	D&C Yellow No. 10 Aluminum Lake, FD&C Blue No. 2 Aluminum Lake, FD&C Red No. 40 Aluminum Lake
4 mg:	FD&C Blue No. 1 Aluminum Lake
5 mg:	D&C Red No. 6 Barium Lake, D&C Yellow No. 10 Aluminum Lake
6 mg:	D&C Yellow No. 10 Aluminum Lake, FD&C Blue No. 2 Aluminum Lake
7.5 mg:	D&C Yellow No. 10 Aluminum Lake

This Medication Guide has been approved by the U.S. Food and Drug Administration.