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Coumadin

Coumadin
Coumadin (Coumadin) is an effective drug capable of prevent life-threatening blood clots. Its application obliges to regularly monitor the degree of blood clotting.

Brand: Warfarin

Availability: In Stock
Average Delivery Time: 9 Days
Exp. Date: September 2023
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Coumadin 5 mg
360 pills - 5 mg
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$161.93 $0.45 $218.35 Add to cart
270 pills - 5 mg
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180 pills - 5 mg $96.27 $0.53 $93.87 Add to cart
120 pills - 5 mg $73.99 $0.62 $52.77 Add to cart
90 pills - 5 mg $60.39 $0.67 $34.68 Add to cart
60 pills - 5 mg $48.75 $0.81 $14.63 Add to cart
30 pills - 5 mg $31.69 $1.06 No Add to cart
Coumadin 2 mg
360 pills - 2 mg
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$105.99 $0.29 $103.71 Add to cart
270 pills - 2 mg $86.99 $0.32 $70.29 Add to cart
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120 pills - 2 mg $48.99 $0.41 $20.91 Add to cart
90 pills - 2 mg $41.97 $0.47 $10.46 Add to cart
60 pills - 2 mg $34.95 $0.58 No Add to cart
Coumadin 1 mg
360 pills - 1 mg
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$105.99 $0.29 $103.71 Add to cart
270 pills - 1 mg $86.99 $0.32 $70.29 Add to cart
180 pills - 1 mg $63.99 $0.36 $40.86 Add to cart
90 pills - 1 mg $41.97 $0.47 $10.46 Add to cart
60 pills - 1 mg $34.95 $0.58 No Add to cart

Product description

What is Coumadin?

Buy Coumadin in Canada

Coumadin (warfarin) is an anticoagulant (blood thinner). Warfarin reduces blood clots.

Coumadin is used to treat or prevent blood clots in veins or arteries, which may reduce the risk of stroke, heart attack, or other serious conditions.

Coumadin may also be used for purposes not listed in this medication guide.

Indications for use Coumadin

Thrombosis treatment with Coumadin

  • treatment and prevention of thrombosis and embolism of blood vessels: acute and recurrent venous thrombosis, pulmonary embolism;

  • secondary prevention of myocardial infarction and prevention of thromboembolic complications after myocardial infarction;

  • prevention of thromboembolic complications in patients with atrial fibrillation, heart valve lesions, or prosthetic heart valves;

  • treatment and prevention of transient ischemic attacks and strokes, prevention of postoperative thrombosis.

Dosage regimen

What Coumadin pills look like

Assign orally, 1 time / day, preferably at the same time. The duration of treatment is determined by the doctor.

MHO should be determined before starting treatment. To determine the MHO value, the patient's blood plasma clotting time (sec) should be divided by 16 (the control plasma clotting time) and the result obtained is raised to a power of 1.12. The therapeutic effect of Warfarin is achieved with MHO 2.0-3.0. Further laboratory control is carried out regularly every 4-8 weeks. The duration of treatment depends on the clinical condition of the patient. Treatment can be canceled immediately.

When combined with other drugs, continuous monitoring (as often as possible) of the INR is required, allowing the dose of Warfarin to be adjusted within 10-15%.

Patients who have not previously taken Warfarin

The initial dose is 5 mg / day (2 tablets / day) for the first 4 days. On the 5th day of treatment, the INR is determined and, in accordance with this indicator, a maintenance dose of the drug is prescribed. Usually, the maintenance dose of the drug is 2.5-7.5 mg / day (1-3 tablets / day).

Patients who have previously taken warfarin

The recommended starting dose is twice the known maintenance dose of the drug and is given within the first 2 days. The treatment is then continued with a known maintenance dose. On the 5th day of treatment, MHO is monitored and the dose is adjusted in accordance with this indicator. It is recommended to maintain the MHO index from 2 to 3 in the case of prevention and treatment of venous thrombosis, pulmonary embolism, atrial fibrillation, dilated cardiomyopathy, complicated heart valve diseases, heart valve replacement with bioprostheses. Higher MHO values ​​from 2.5 to 3.5 are recommended for prosthetic heart valves with mechanical prostheses and complicated acute myocardial infarction.

Children

Data on the use of warfarin in children are limited. The initial dose is usually 0.2 mg / kg / day for normal liver function and 0.1 mg / kg / day for liver dysfunction. The maintenance dose is selected in accordance with the MHO indicators. The recommended MHO levels are the same as for adults. The decision on the appointment of Warfarin to children should be made by an experienced specialist. Treatment should be supervised by an experienced pediatrician.

Contraindications for use

  • acute bleeding;

  • severe renal dysfunction;

  • severe liver dysfunction;

  • severe kidney disease;

  • severe liver disease;

  • severe arterial hypertension;

  • acute disseminated intravascular coagulation syndrome;

  • deficiency of proteins C and S;

  • thrombocytopenia;

  • pregnancy;

  • patients with a high risk of bleeding, including patients with hemorrhagic disorders, varicose veins of the esophagus, aneurysm of the arteries, lumbar puncture, gastric ulcer and duodenal ulcer, with severe wounds (including operating ones), bacterial endocarditis, malignant arterial hypertension, hemorrhagic stroke ;

  • established or suspected hypersensitivity to drug components.

Application during pregnancy and lactation

The use of warfarin during pregnancy is contraindicated.

Warfarin quickly penetrates the placental barrier, has a teratogenic effect on the fetus (nasal hypoplasia, chondrodysplasia, optic nerve artophy, cataracts leading to complete blindness, mental and physical retardation, microcephaly) and can cause bleeding at the end of pregnancy and during childbirth.

If necessary, use during lactation should suspend breastfeeding in the first 3 days of treatment. When used during breastfeeding, warfarin is excreted in breast milk in small quantities and does not affect blood coagulation processes.

Application for impaired liver function

Use with caution in case of impaired liver function

Use with impaired renal function Use with

caution in case of impaired renal function

Use in elderly patients

Use with caution in elderly patients

Use in children

In pediatric patients, the use of Warfarin is limited and should be supervised by an experienced pediatrician ...

Special instructions

A prerequisite for therapy with Warfarin is strict adherence to the patient taking the prescribed dose of the drug.

Drinking alcohol increases the risk of hypoprothrombinemia and bleeding. Patients with alcoholism as well as patients with dementia may not be able to adhere to the prescribed regimen of warfarin.

Conditions such as fever, hyperthyroidism, decompensated heart failure, alcoholism with concomitant liver damage can enhance the effect of warfarin. In hypothyroidism, the effect of Warfarin may be reduced.

In the case of renal failure or nephrotic syndrome, the level of the free fraction of Warfarin in the blood plasma increases, which, depending on concomitant diseases, can lead to both an increase or a decrease in the effect.

In the case of moderate hepatic impairment, the effect of Warfarin is enhanced.

In all of the above conditions, the MHO level should be closely monitored.

For patients receiving warfarin, paracetamol, tramadol, or opiates are recommended as pain relievers.

Patients with a mutation in the gene encoding the isoenzyme CYP2C9 have a longer T1/2 warfarin. These patients require lower doses of the drug because when taken in usual therapeutic doses, the risk of bleeding increases.

If it is necessary to develop a rapid antithrombotic effect, it is recommended to start treatment with the introduction of heparin; then, for 5-7 days, combination therapy with heparin and warfarin should be carried out until the target MHO level is maintained for 2 days.

To avoid coumarin necrosis, patients with hereditary antithrombotic protein C or S deficiencies must first be given heparin. The concomitant initial dose should not exceed 5 mg. Heparin administration should be continued for 5-7 days.

In the case of individual resistance to Warfarin (very rare), 5 to 20 loading doses of Warfarin are required to achieve a therapeutic effect. If taking Warfarin in such patients is ineffective, other possible reasons should be established:

  • simultaneous administration of Warfarin with other drugs, inadequate diet, laboratory errors.

Treatment of elderly patients should be carried out with extreme caution, because the synthesis of coagulation factors and hepatic metabolism in such patients is reduced, as a result of this, the development of an excessive effect of warfarin is possible.

Do not prescribe the drug Warfarin to patients with hereditary galactose intolerance, lactase enzyme deficiency, impaired absorption of glucose and galactose.

Use in Pediatricspediatric

Inpatients, the use of Warfarin is limited and should be supervised by an experienced pediatrician.

Overdose

Symptoms:

  • bleeding, bleeding. The indicator of the effectiveness of treatment is at the border of the development of bleeding, so the patient may have minor bleeding, for example, microhematuria, bleeding of the gums.

Treatment:

  • in mild cases, it is enough to reduce the dose of the drug or stop treatment for a short time. For minor bleeding, it is sufficient to stop taking the drug until the target MHO level is reached. In case of severe bleeding, the administration of vitamin K (i.v.) and activated carbon, concentrate of coagulation factors or fresh frozen plasma. If oral anticoagulants are indicated for future prescription, large doses of vitamin K should be avoided because resistance to warfarin develops within 2 weeks.


Possible side effects 

Taking Coumadin increases the risk of bleeding. Light bleeding, such as minor bruising or hemorrhage in the lining of the eye, is common. Serious life-threatening bleeding is much rarer. If one or more of the following symptoms develop, you should see a doctor immediately: Hematomas or swelling with hypersensitivity for no apparent reason Severe, prolonged headache 

  • Bleeding from the nose 
  • Sputum with blood 
  • Severe bleeding from the gums after brushing the teeth 
  • Prolonged bleeding from a small cut 
  • menstrual bleeding in excess of normal Unexplained abdominal pain 
  • bloody vomit 
  • Black feces or stool with blood, 
  • urine with blood 
  • Severe prolonged back pain with no apparent cause 
  • head trauma 

Rare side effects that require medical consultation 

  • rash or irritation on the skin 
  • temperature 
  • sore throat 
  • Dizziness 
  • Weakness or unusual tiredness 
  • Lack of appetite for several days 
  • Diarrhea Nausea with or without vomiting