Coumadin (Warfarin) Overdose

What is warfarin?

Names:  Warfarin, Coumadin, and Jantoven are different names or brand names for the same medication.

Warfarin is an anticoagulant.  Although warfarin is sometimes referred to as a “blood thinner,”  this drug does not actually thin blood.  Instead. anticoagulants like coumadin help reduce the number of clots that form in blood.

Warfarin does not break up existing clots – it only helps to prevent new clots from forming.  Warfarin is the generic formulation of Coumadin.  Warfarin may be prescribed for a variety of reasons including to help prevent heart attacks, strokes, and blood clots in veins and arteries.

Medication prescribing information states the following warnings:

  • Warfarin sodium can cause major or fatal bleeding.
  • Regular monitoring of INR* is required for all patients treated with warfarin.
  • Drugs, dietary changes, and other factors affect INR levels achieved with warfarin sodium therapy.
  • Patients should be fully advised about prevention measures to minimize the risk of bleeding and told to report all signs and symptoms of bleeding.

Other serious risks associated with warfarin include tissue necrosis or gangrene that may result in amputation or death.  For a complete list of warnings, risking, and prescribing information read Prescribing Information for Warfarin Sodium Tablets.

*Note:  INR stands for International Normalized Ratio.  INR is a system established by the World Health Organization and the International Committee on Thrombosis and Hemostasis for reporting the results of blood coagulation (clotting) tests. You will need frequent “INR” or prothrombin time tests (to measure your blood-clotting time and determine your warfarin dose).

Increased Risk Factors For Bleeding Problems While Taking Warfarin

Warfarin can make you bleed more easily, especially if you have ever had:

  • high blood pressure or serious heart disease;
  • kidney disease;
  • cancer or low blood cell counts;
  • an accident or surgery;
  • bleeding in your stomach or intestines;
  • a stroke; or
  • if you are 65 or older.

How Warfarin(Coumadin) Works

The formation of a clot in the body is a complex process that involves multiple substances called clotting factors. Warfarin decreases the body’s ability to form blood clots by blocking the formation of vitamin K–dependent clotting factors. Vitamin K is needed to make clotting factors and prevent bleeding.

For this reason, health professionals recommend patients taking warfarin limit certain foods that are rich in vitamin K, including, Kale, spinach, brussels sprouts, parsley, collard greens, mustard greens, chard, and green tea.

Side Effects — Warfarin (Coumadin) Overdose is Life Threatening

Serious side effects that may indicate an overdose and should be reported immediately to the patient’s prescribing doctor include:

  • pain, swelling, hot or cold feeling, skin changes, or discoloration anywhere on your body;
  • small, flat, round purple or red spots under the skin;
  • sudden and severe leg or foot pain, foot ulcer, purple toes or fingers;
  • sudden headache, dizziness, or weakness;
  • heavy bleeding with your menstrual period;
  • unusual bleeding (nose, mouth, vagina, or rectum), bleeding from wounds or needle injections, any bleeding that will not stop;
  • easy bruising;
  • pink, red, or dark brown urine;
  • black or bloody stools;
  • spitting up or coughing up blood or vomit that looks like coffee grounds;
  • pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating;
  • dark urine, jaundice (yellowing of the skin or eyes);
  • pain in your stomach, back, or sides;
  • urinating less than usual or not at all;
  • numbness or muscle weakness; or
  • any illness with diarrhea, fever, chills, body aches, or flu symptoms.

Less serious side effects may include:

  • nausea, vomiting, mild stomach pain;
  • bloating, gas; or
  • altered sense of taste.

Treatment for an Overdose of Warfarin, Coumadin, Jantoven

In serious bleeding caused by warfarin therapy (over-anticoagulation), rapid warfarin reversal is required. A number of options for warfarin reversal are available, including the withdrawal of oral anticoagulants and administration of Vitamin K.  Left untreated, warfarin overdose can lead to amputation or death.

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Sources:

Mayo Clinic, Warfarin Diet: What foods should I avoid? Sheldon G. Sheps, M.D.