Coumadin vs Warfarin

[Laurie]

Linda, a normal value is 2-3 for most diagnosis and 2.5 - 3.5 for most valve disorders or high risk patients. It depends on why you are on it.

[David]

Re: Post by Nancy

I have been on Warfarin for ten years, mostly taking 3mg.
Some years ago I went on part time shift work, working 19:00 to 07:00 three days a week, same days.
My dosages changed from a flat line 3mg previous, to 2.5mg, then 3.5mg daily, I think depending on which day I had the INR
I don't think warfarin has been thoroughly tested or researched regarding shift workers.
I was worried that if I was tested on a day which scored a 3.5 mg dosage, this would be a massive overdose for when scores would have been 2.5mg

[Laurie]

David it actually wouldnt have been that much off. It would have most likely still been in range just a little higher or lower but should have still been okay. Hope that helps.

[David]

Laurie wrote:

David it actually wouldnt have been that much off. It would have most likely still been in range just a little higher or lower but should have still been okay. Hope that helps.

Compared to some posts here, plus or minus 0.5mg on the original 3mg daily may not have been that big,but I got headaches and nose bleeds when on 3.5mg. The nature of the shift work meant it was hard not to be up awake 24 hours at the start of the shift, and endeavouring to sleep 24 hours at the end of the three days. Since ceasing this work I no longer oscillate, back to about 3mg of the outset 10 years ago. So is there actual research on the effect of shift patterns or is the shouldn't change much a theoretical prediction? My comment was posted following the similar report posted here, with a range of 2.5-4.1 daily.

[Laurie]

David I am a nurse and I have managed hundreds of patients. So I do have expertise in the area or I wouldnt offer advice. If I can explain a little better maybe it would help. Your Inr gives you a reading of the amount of coumadin in your system over a period of time. The time we use to adjust your dose is 7 days - so sometimes if you alternate what your dose is weekly, your inr may be a little lower or higher because of the difference in mgs you had for the week. For example: If you take 5mg alternating with 2.5mg - one week you will have an extra 2.5mg for the week which may cause a slight bump in the inr. The way I kept my patients regulated was to give them a set dosage. For example I would try 5mg 4 days a week and 2.5mg the other 3. If that was too much, I would switch their dose to 2.5mg 4 days a week and have them take 5mg 3 days. Its easier to regulate someone this way as opposed to the alternating days. I hope I explained myself better for you. As far as shift work, I cant say I have ever seen this but nothing is impossible :)

[Rica Aust]

My husband is on Coumadin tablets (Warfarin). He has been experiencing on an off blurring and black out of vision in one eye. I am deeply concerned and at a loss because his doctor does not seem to think it has any relation to the medication. Are there other people out there experiencing this sort of problem?
Many thanks.

[Laurie]

Rica - your doctor is wrong, SORRY MY CAPS LOCK IS STUCK ON NOW - he can have a hemmorrhage in his eye. Does he have diabetes? I highly recommend taking him to an eye DOCTOR TO HAVE IT CHECKED.

[Rica Aust]

Hi Laurie, thanks for the reply. I had suspected my husband's condition to be the side effect of his medications. So I Googled to see what I could find. I am now suspecting that Coumadin may have contributed to his vision problem. I am particularly concerned as my husband as only one good eye because of an accident many years ago. If his only eye is affected, then he could go blind and that would be so tragic. No, my husband does not have diabetes. Yes, he has seen an eye doctor and was told his eye was in good condition. I have booked my husband to see a specialist next Tuesday and will ask him to discuss the possibility of haemorrhage of the eye in conjunction with Coudamin. Kind regards Rica

[Rhea]

I have been on Warfarin since Jan of 09'. I am having multiple side effects. The ones that trouble me the most is depression, lack of energy, and most frustrating confusion and short term memory trouble. These side effects are actually effecting my work and daily life. After reading some of your troubles I am going to ask to try coumadin instead of warfarin to see if there is a difference for me. Thank you all.

[Robert]

I am in warfarin since 1 year and was in coumadin for 5 mounts. I am in a-fib and clots on my heart. the first time I was in coumadin, I avoid all greens salads and any food that contain vitamin K and my PT was going up to 6. Finally, I understand that you should continue with you daily portion of salad, not avoid them.
Actually, I am taking 5 mg daily and it's work perfectly for me.
The depression come because you put it in your head, not from the medicine by itself.
Let's be positive and it will work.

[esimac]

Ira PharmD wrote:

Michelle, what color is your Coumadin (warfarin) tablet and how many tablets do you take per day? I think you are mistaken on your dose. I have not seen a dose that high in several years of practice. Perhaps you mean that you take 40 mg per week which was reduced to 30 mg per week? It would be less than 1% of people who require a dose of higher than 15 mg per day (i.e. 105 mg per week).
As for the difference between warfarin and coumadin, there are different binders but the same amount of actual thinning in generic versus brand; moreover, the generic company has to submit evidence that there is very little variation between the brand and generic, or even batches of generic to itself.
A difference in release rates don't play in that much as it takes roughly 4 days at minimal and as much as 2 weeks to see an INR change following dose adjustments. There are far too many factors playing into INR changes (illness, alcohol, tylenol use, leafy greens or other dietary changes, herbal drugs, drug interactions, taking other meds one day and forgetting another day, age, or even exercise changes), and in one third of people it changes with no apparent reason.

Obviously the comments from a Pharmicist, or DR. AND I am so glad to hear them, because I was starting to get panicky reading all these horror-stories. I'm 73, and go to the VA Clincs which I don't have alot of confidence in, and have been on Warferin @ 7.5mg on four days and 5mg for 3 days per week for A-FIB. Have taken this for about 8 years now, along with .25mg digoxin daily to control heart function and rate. I have always been concerned about the "rat-poison" thing, and all. THANKS for allaying my fears.

[Maria34]

I find some information about Coumadin (Warfarin) at http://warfarins.org There is description of side effects, dosage, using of this medicine. Hope it will be useful.

[Rhonda]

My 18 yr son is on coumadin/warfarin 5mg, 50mil a week,he has blood work done once a week. He will have to continue this for the rest of his life.It's hard to make him understand the import of this. He suffered from pulmonary embolisim, was in intenive care for a month.He seems to think that hes fine now.

[unknown user]

warfin and coumadin are one and the same medicine
like ibuprofin and motrin same thing just so you know. one is the main name and the other is the medical name.
i been on coumadin/ warfin for a year from a stroke.

[Gwen]

Coumadin is a brand name for warfarin. Many companies now market generic warfarin. My HMO provided Coumadin before the generics were availible. When the generics became availible, the generic source were Barr Pharmaceuticals until last December when the source changed to Taro Pharmaceuticals. The color of the tablets remain consistent - a pink tablet is 1 mg across the board. The shape may change with the manufacturer.

It is like Tylenol is a brand name of acetaminophen. There are many private labels of generic acetaminophen.

[marti]

I just switched from coumadine to warafin for financial reasons. Noe I am having aches in my legs and feet and it appears like arthritus.

[marti]

Iust switched from coumadine to warafin for financial reasons. Since then my legs and feet hurt and feel arthriric.

[Lisa RN]

I work in a cardiac ICU as a RN, and I haven't seen Coumadin affect people the same way twice. Some seem to be resistant, requiring higher and higher dosages to get an INR in the 2-3 range, some have INRs that continue to go up past 3, even after coumadin is discontinued. I think it is important to remember why you are taking the medication. If you have a problem that is treatable with Coumadin, then you should treat it. Problems requiring Coumadin or other blood thinners very often have very serious complications such as DVT, pulmonary embolus, heart attacks (MI), stroke, or any other clot induced problems - most of which can be deadly. Just make sure you monitor your blood levels closely, and you should be fine. As for the difference in brand name and generic, some people seem to be sensitive, but most have no problems switching at all.

esimac wrote:

<quoted text>
Obviously the comments from a Pharmicist, or DR. AND I am so glad to hear them, because I was starting to get panicky reading all these horror-stories. I'm 73, and go to the VA Clincs which I don't have alot of confidence in, and have been on Warferin @ 7.5mg on four days and 5mg for 3 days per week for A-FIB. Have taken this for about 8 years now, along with .25mg digoxin daily to control heart function and rate. I have always been concerned about the "rat-poison" thing, and all. THANKS for allaying my fears.

[Carol]

In 2002, I took generic warfarin for several months and my INR was so erratic that once it was 9 one day and 1 two days later. My upper arms were covered with tiny scabs where the blood was trying to seep out when it was 9. At that point I began to research it and found a study on the American Academy of Family Practice (a 2000 study) which said that 39% of generic warfarin patients ever get regulated but 63% of Coumadin patients get regulated. I printed it out for my hemotologist and she said they had several patients that might benefit from changing to Coumadin who were also erratic and would switch them.

[Laurie]

Carol - I wouldnt go by studies alone - many reasons for not being able to regulate someone has nothing to do with generic or brand - it is because the doctor doesnt know what he/she is doing.