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Coumadin is an anticoagulant (blood thinner). Coumadin reduces the formation of blood clots, which is important in the prevention of heart attacks, strokes, and blockage of major veins and arteries.

Take Coumadin exactly as directed on the package or as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you. Take each dose with a full glass of water. It can be taken with or without food. Never take more of this medication than is prescribed for you.

This drug may cause following serious side effects :an allergic reaction (difficulty breathing, closing of the throat, swelling of the lips, tongue, or face, or hives), black, bloody, or tarry stools, blood in urine or vomit, coughing up blood, bleeding gums or sores in the mouth, decreased urine production, yellowing of the skin or eyes, severe dizziness or headache, easy bleeding or bruising under the skin, purple discoloration of the toes or fingers, sudden leg or foot pain, or unusually heavy menstrual periods. Other, less serious side effects may be more likely to occur. Talk to your doctor if you experience excessive gas or bloating, diarrhea, nausea, or vomiting, hair loss, or decreased appetite or weight.

Tell your doctor your medical history, including : recently had surgery, have a stomach ulcer or bleeding in the stomach, have had a certain type of stroke caused by bleeding in the brain, have had an aneurysm, recently had a spinal puncture or lumbar block anesthesia, or have bacterial endocarditis (infection of the heart), pericarditis (swelling of tissue around the heart), or pericardial effusion (build-up of fluid around the heart). Before taking Coumadin, tell your doctor if you: have kidney disease, have liver disease, have high blood pressure, have a hereditary protein C or protein S deficiency, are diabetic, have polycythemia vera, have vasculitis, have congestive heart failure, have a collagen vascular disorder such as systemic lupus erythematosus, have thyroid disease, have high cholesterol, have cancer, have a vitamin K deficiency, are considering having surgery, or are taking antibiotics to treat an infection. Coumadin is in the FDA pregnancy category X. This means that Coumadin is known to cause birth defects in an unborn baby and must not be taken during pregnancy. Do not take Coumadin if you are pregnant or could become pregnant during treatment. Consult your doctor immediately if you become pregnant while taking Coumadin. Use caution when driving, operating machinery, or performing other hazardous activities. Coumadin may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities and notify your doctor. Also use caution when rising from a sitting or lying position. Use alcohol cautiously. Alchol may further lower blood pressure and increase drowsiness and dizziness while you are taking Coumadin.Avoid sudden changes in your diet. Vitamin K decreases the effects of Coumadin. Large amounts of vitamin K are found in foods such as liver, broccoli, brussels sprouts, and green leafy vegetables (e.g., spinach, Swiss chard, coriander, collards, cabbage). Do not change the amount of these foods in your diet without first talking to your doctor. Do not take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil, Nuprin, others), ketoprofen (Orudis, Orudis KT, Oruvail), naproxen (Naprosyn, Aleve, Anaprox) and others while taking Coumadin, except under the direction of your doctor. These medicines increase the risk of bleeding.

Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal supplements, during treatment with Coumadin.

If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include bruising, small, broken blood vessels under the skin, excessive bleeding from cuts or wounds, bleeding from the gums, blood in the stools, urine, or vomit, and excessive menstrual bleeding in women.

Do not share Coumadin with others.

If you miss an Coumadin dosage, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up.

Store Coumadin at room temperature between 68 and 77 degrees F (20-25 degrees C) away from sunlight and moisture.

The following Informationrmation is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist or other healthcare professional. It should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. Consult your healthcare professional before using this drug.