Coumadin (Warfarin) for Lupus

Overview
Coumadin is a prescription drug approved by the Food and Drug Administration (FDA) in 1954 to reduce the risk for blood clots, strokes and heart attacks. Coumadin is also known by its drug name, Warfarin. In lupus, Coumadin is often prescribed as long-term therapy for people with lupus who test positive for antiphospholipid antibodies. Approximately one-third of people with lupus have these antibodies, which significantly raise the risk for blood clots and related complications.

Coumadin should not be used by pregnant women. Coumadin may not be appropriate for those with blood-related disorders such as low platelet count (thrombocytopenia) or for people who have shown hypersensitivity to Coumadin in the past.

Coumadin is a member of a class of drugs called anticoagulants, which reduce the ability of blood to form clots. Coumadin is believed to work by interfering with Vitamin K, which the body needs in order to produce proteins that allow blood to clot.

How do I take it?
Coumadin is usually taken orally as a tablet, but it can also be injected. Since each person responds differently to Coumadin, your doctor will determine dosage and administration based on your condition, age, size, weight and other factors.

Your doctor may prescribe blood tests and clotting time tests before you begin taking Coumadin and regularly during the time you are taking it.

Women should use effective birth control while taking Coumadin.

Avoid taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen and supplements that contain Vitamin K while taking anticoagulants. Do not smoke or drink alcohol while taking anticoagulants, as these substances may lower the effectiveness of the drug and increase the risk of side effects.

Always follow your doctor’s instructions exactly when taking Coumadin.

Results
Several studies have proven the effectiveness of Warfarin (Coumadin) at preventing blood clots in people with antiphospholipid antibodies.

Side effects
Common side effects of Coumadin include easy bleeding and bruising. Call your doctor immediately if you experience a nosebleed, blood in your urine, black, tarry-looking stools, unusual vaginal bleeding, or bleeding that will not stop.

Coumadin can cause significant bleeding that may become fatal. The risk for this side effect is greatest within the first month of taking Coumadin and among those older than 65 or with a history of gastrointestinal bleeding, cancer, kidney problems, and some genetic factors.

Other rare but serious side effects of Coumadin include the death of skin or other tissues known as necrosis or gangrene, liver damage, and the release of tiny blood clots (systemic atheroemboli and cholesterol microemboli). Notify your doctor if you experience purple fingers or toes, sudden, severe pain in legs or feet, yellowing of the eyes or skin, swollen or painful abdomen, or pain, swelling or skin discoloration anywhere on the body.

If taken during pregnancy, Coumadin may cause birth defects and fetal bleeding.

Many drugs can cause allergic reactions which, in the most serious cases, can result in death. Seek immediate medical help if you experience signs of a severe allergic reaction such as difficulty breathing or swelling in the face, throat, eyes, lips or tongue.