Warfarin Tablet: Uses, Dosage & Side Effects in Pakistan

Warfarin Tablet Uses, Dosage, Side Effects & Price in Pakistan

1. Quick Info (Mukhtasir Maloomat)

2. What is Warfarin Tablet? (Warfarin Tablet kya hai)

Warfarin Tablet (Warf / Coumadin) is used in Pakistan for blood clotting disorders. It belongs to the Vitamin K Antagonist (VKA) Anticoagulant class, with Warfarin as the active ingredient. Warfarin inhibits the Vitamin K epoxide reductase (VKOR) enzyme, blocking the activation of clotting factors II, VII, IX, and X — this keeps the blood thin and prevents harmful clots from forming. The full effect takes 2–3 days because the existing clotting factors must first be depleted. The dose is always adjusted by the doctor based on the INR blood test result — NEVER self-adjust the dose.

3. Uses (Fayde / Kis kaam aati hai)

• Deep Vein Thrombosis (DVT) — treatment and prevention
• Pulmonary Embolism (PE) — treatment and prevention
• Atrial Fibrillation (AF) — stroke prevention
• Mechanical heart valves — lifelong anticoagulation
• Venous thromboembolism prevention — post-surgery
• Recurrent thromboembolism prevention — preventing repeated clots

4. Who Should Take (Kis ko leni chahiye)

• Patients with current or history of DVT or PE who have been prescribed it by a doctor
• Atrial fibrillation patients at stroke risk who have been recommended it by a doctor
• Mechanical heart valve patients — lifelong
• Patients on specialist-prescribed post-surgery thromboembolism prophylaxis

5. When NOT to Take (Kab nahi leni chahiye)

• NEVER during PREGNANCY — Category X teratogen (embryopathy risk); use LMWH instead
• Active major bleeding (GI, intracranial, surgical site)
• Allergy to warfarin or any ingredient
• Severe liver disease or severe renal impairment
• Uncontrolled hypertension
• Recent neurosurgery, eye surgery, or spinal surgery
• History of haemorrhagic stroke

6. Dosage (Kitni leni hai)

• Doctor-determined — typically 5mg once daily; lower (2–3mg) in elderly, small body weight, CYP2C9/VKORC1 polymorphism, or warfarin-sensitive patients

• Highly individualized — adjusted by doctor based on INR results every few days initially, then every 4–8 weeks when stable; INR target 2.0–3.0 for most indications, 2.5–3.5 for mechanical heart valves

• No fixed maximum — dose adjusted purely by INR target; dose that achieves therapeutic INR without over-anticoagulation

• If you forget a dose, take it as soon as you remember that day — but if it is close to the next dose time, skip it. NEVER take a double dose. Inform your doctor about the missed dose as it may affect the INR.

7. How to Take (Kaise leni hai)

• Once daily — always take at the same time

• At the same time each day — consistency is essential for INR testing

• Evening preferred

• With or without food — but keep the vitamin K content of meals consistent

8. Best Time (Kab leni chahiye)

• Evening — the standard recommendation of anticoagulation clinics

• Same time daily to maintain a routine — for dose consistency and INR stability

9. Empty Stomach or After Food (Khali pait ya khane ke baad)

Warfarin can be taken at any time — with or without food — but avoid sudden changes in diet (especially vitamin K-rich foods). A consistent diet is essential for INR stability. If any major change in diet occurs, inform your doctor.

10. Warnings (Ihtiyat)

• PREGNANCY CONTRAINDICATED — Category X (embryopathy); switch to LMWH
• Active major bleeding
• Allergy to warfarin
• History of haemorrhagic stroke

• REGULAR INR TEST: INR target 2.0–3.0 (most indications), 2.5–3.5 (mechanical valves)
• INR < 2.0 = under-anticoagulated (clot risk); INR > 4.0 = over-anticoagulated (major bleeding risk)
• INR > 5.0 = reversal usually required (Vitamin K1, FFP — doctor emergency action)
• Always carry your anticoagulation card — inform all doctors, dentists, and pharmacists

11. Precautions (Ahm ehtiyaat)

• Store in a cool, dry place (below 30°C)
• Keep away from direct sunlight and moisture
• Keep completely out of reach of children

• Avoid hazardous sports (contact sports, extreme activities) — bleeding risk
• Avoid alcohol — it unpredictably affects INR and increases bleeding risk
• Consult your doctor before starting any new supplement, herbal, or OTC medicine

12. Side Effects (Nuksanat)

• Bleeding
• Nausea (mild)
• Hair loss — alopecia (reversible)

• Intracranial haemorrhage
• Major GI haemorrhage
• Warfarin-induced skin necrosis
• Purple toe syndrome (rare)
• Long-term osteoporosis
• Teratogenicity

13. Drug Interactions (Dawaon ke sath reaction)

• MAJOR — INR-INCREASING (bleeding risk): amiodarone, fluconazole, metronidazole (CYP2C9 inhibitors), ciprofloxacin, clarithromycin, omeprazole, paracetamol (high dose), aspirin/NSAIDs (additive bleeding), clopidogrel (platelet inhibition)
• MAJOR — INR-DECREASING (clot risk): rifampicin (MAJOR CYP2C9 inducer — drastically reduces INR), carbamazepine, phenytoin, vitamin K supplements, St. John's Wort
• Herbal supplements: ginkgo, garlic, ginger — increase bleeding risk
• When starting any new medicine, ALWAYS inform your doctor or pharmacist about warfarin — an interaction check is mandatory.

14. When to See Doctor (Kab doctor ke paas jayein)

• Unusual or excessive bleeding — bruising, nosebleed, pink/red urine, black/tarry stool
• EMERGENCY: Severe headache, weakness, or visual disturbances — signs of intracranial haemorrhage; call emergency services immediately
• Blood in vomit
• Severe or unusual wounds or lacerations
• Chest pain or difficulty breathing (PE/MI)
• If any new medicine, supplement, or high-vitamin-K food has been started

15. Alternatives (Sasti Dusri Dawaein)

Note: DOACs (apixaban, rivaroxaban, dabigatran) are preferred over warfarin for AF/VTE due to no INR monitoring requirement — EXCEPT for mechanical heart valves and antiphospholipid syndrome where warfarin remains the standard. Consult your doctor.

16. Price in Pakistan (Price kitni hai)

17. FAQs (Aksar poochay jane walay sawalat)

Q: Warfarin kis kaam aata hai?

A: Warfarin is used to prevent blood clots in DVT, PE, atrial fibrillation, and mechanical heart valves. It is a Vitamin K antagonist (VKA) anticoagulant that blocks clotting factors.

Q: Warfarin ke saath kaunsa khana band karna chahiye?

A: No food needs to be stopped — but vitamin K-containing foods (spinach, broccoli, leafy greens, green tea, liver) must be kept CONSISTENT. Suddenly increasing or decreasing them disturbs the INR. Avoid alcohol and cranberry juice.

Q: Warfarin ka INR test kyon karana chahiye?

A: The INR measures the effect of warfarin. The target range is 2.0–3.0 — going outside this range increases the risk of both clots and bleeding. Regular monitoring is essential for dose safety.

Q: Pakistan mein warfarin price kitni hai?

A: Warf tablets are available in Pakistan — confirm the exact current price at your local pharmacy or dawaai.pk.

Q: Warfarin pregnancy mein kyun nahi leni chahiye?

A: Warfarin is a Category X teratogen. It carries a risk of foetal warfarin embryopathy in the first trimester and foetal haemorrhage later in pregnancy. LMWH (enoxaparin injections) is prescribed by doctors during pregnancy instead.

18. Medical Review (Medical jaiza)

Compiled by the PakVita Editorial Team · AI-assisted drafting with editorial review · Sourced from DRAP, WHO, BNF · Last updated: 2026-06-17

19. Disclaimer (Zaroori tanbeeh)

The information on this page is for awareness only. It is not medical advice. Always consult your doctor or pharmacist before taking any medicine. PakVita is not responsible for any harm.