와파린 나트륨

용도

• Adjunctive maintenance therapy for venous thrombosis with or without pulmonary thromboembolism (PTE)
• Maintenance therapy for feline arterial thromboembolism
• Long-term thromboprophylaxis
• Adjunctive therapy of thromboembolism
• Cardiogenic arterial thromboembolism
• Adjunctive treatment of laminitis
• Anticoagulant
• Adjunctive maintenance therapy for venous thrombosis with or without pulmonary thromboembolism (PTE)
• Adjunctive therapy of thromboemboli
• Prophylactic use in patients with glomerular disease and severe proteinuria

투여 방법

가능한 부작용

• Dose-related hemorrhage (primary adverse effect)
• Anemia
• Thrombocytopenia
• Weakness
• Hematomas and ecchymoses
• Epistaxis (nosebleeds)
• Hematemesis (vomiting blood)
• Hematuria (blood in urine)
• Melena (dark, tarry stools)
• Hematochezia (fresh blood in stools)
• Hemarthrosis (bleeding into joints)
• Hemothorax
• Intracranial hemorrhage
• Pericardial hemorrhage
• Death

주의사항 및 금기

• Preexistent hemorrhagic tendencies or diseases
• Patients undergoing or contemplating eye or CNS surgery
• Major regional lumbar block anesthesia
• Surgery of large, open surfaces
• Active bleeding from the GI, respiratory, or GU tract
• Aneurysm
• Acute nephritis
• Cerebrovascular hemorrhage
• Blood dyscrasias
• Uncontrolled or malignant hypertension
• Hepatic insufficiency
• Pericardial effusion
• Pregnancy (Teratogenic - FDA Category X / Papich Class D)
• Visceral carcinomas
• > **Strict Monitoring Required:** Warfarin has a narrow therapeutic index. Frequent monitoring of coagulation status (PT/INR) is mandatory to prevent fatal hemorrhage. * **Teratogenicity:** Warfarin is embryotoxic and causes congenital malformations. It is strictly contraindicated in pregnancy. Low-dose heparin is preferred if anticoagulation is required during pregnancy. * **Nursing:** Use with caution in nursing patients; prolonged prothrombin times have been reported in some breast-fed human infants. * **Dietary Changes:** Sudden changes in diet (especially foods high in Vitamin K) can alter the efficacy of warfarin. * **Laboratory Interference:** May cause falsely decreased theophylline values if using the Schack and Waxler ultraviolet method.

약물 상호작용

• Acetaminophen, NSAIDs, Salicylates: May increase anticoagulant response (via protein displacement or platelet inhibition); increases bleeding risk.
• Fluoroquinolones, Macrolides (Azithromycin, Erythromycin), Chloramphenicol, Sulfonamides, Co-trimoxazole: May increase anticoagulant response (often via inhibition of hepatic metabolism).
• Cimetidine, Cisapride, Fluoxetine, Metronidazole, Sertraline: May increase anticoagulant response.
• Amiodarone, Allopurinol, Danazol, Diazoxide, Ethacrynic acid, Pentoxifylline, Propylthiouracil, Quinidine, Zafirlukast: May increase anticoagulant response.
• Anabolic Steroids, Thyroid Medications: May increase anticoagulant response.
• Heparin: Increases anticoagulant response; often used concurrently during the initial overlap phase but requires careful monitoring.
• Barbiturates (e.g., Phenobarbital), Rifampin, Griseofulvin: May decrease anticoagulant response (via induction of hepatic metabolizing enzymes).
• Corticosteroids, Estrogens, Mercaptopurine, Spironolactone, Sucralfate: May decrease anticoagulant response.
• Vitamin K: Directly antagonizes warfarin, decreasing its anticoagulant response (used as an antidote for overdose).

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