Warfarin Sodium Tablets fo rmyocardial infarction or thrombosis. (60 tablets* 5 boxes/lot).

Huafalinna Pian

Hua Fa Lin Na Pian

华法林钠片

Warfarin Sodium Tablets fo rmyocardial infarction or thrombosis

ACTIONS and INDICATIONS
For patients who need long-term continuous anticoagulation:
1.It can prevent the formation and development of thrombosis, for the treatment of thromboembolic diseases;
2.For the treatment of venous thrombosis after surgery or trauma, and can be used as an auxiliary medication for myocardial infarction;
3.For patients with thromboembolic disease and those with postoperative thrombotic complications, preventive medication may be given.

INGREDIENTS
Warfarin Sodium.

PROPERTIES
Filmed tablets.

Spec.
2.5mg*60 tablets/box.

USAGE AND DOSAGE
Oral,adults' usual dose: Avoid impact treatment for oral administration of 3 to 4 mg on the 1st to 3rd day (half dosage for frail and diabetic patients). After 3 days, the maintenance dose can be 2.5 to 5 mg per day (refer to the clotting time to adjust the dose to make the INR value). Up to 2 to 3). Due to the slow onset of this product, there may be a transient hypercoagulable state due to inhibition of plasma anticoagulant cells in the first 3 days of treatment. If anticoagulant effect is required immediately, heparin may be applied at the same time. After the product fully exerts anticoagulant effect Heparin is then discontinued..

ADVERSE REACTION
Excessive bleeding can cause various bleeding. Early manifestations include ecchymosis, purpura, bleeding gums, nasal discharge, wound bleeding, long-term unhealed, and excessive menstrual flow. Bleeding can occur anywhere, especially in the urinary and digestive tract. Intestinal wall hematoma can cause subacute intestinal obstruction, as well as subdural intracranial hematoma and hematoma at the puncture site. Occasionally, adverse reactions include nausea, vomiting, diarrhea, pruritic rash, allergic reactions and skin necrosis. A large number of oral or even bilateral breast necrosis, microvascular disease or hemolytic anemia and a wide range of skin gangrene.

CONSTRAINDICATION
Liver and kidney dysfunction, severe hypertension, coagulopathy with bleeding tendency, active ulcers, trauma, threatened abortion, banned in recent surgery. Disabled during pregnancy. Older people or menstrual periods should be used with caution.

PRECAUTION
1.The elderly or menstrual period should be used with caution.
2.Strictly control the indications. Do not abuse this product without the conditions of prothrombin determination.
3.Individual differences are big, the condition should be closely observed during the treatment, and the dosage should be adjusted according to the INR value of prothrombin time. During the treatment, oral mucosa, nasal cavity, subcutaneous hemorrhage, fecal occult blood, hematuria, etc. should be closely observed. During the medication, unnecessary surgical operations should be avoided. The elective surgery should be stopped for 7 days, and the emergency surgery operator should correct the PTINR value ≤1.6. Avoid overwork and activity that is prone to injury.
4.If mild hemorrhage occurs, or the prothrombin time has been significantly longer than 2.5 times normal, the dose should be reduced or discontinued. Severe bleeding can be intravenously injected with vitamin K1010mg to control bleeding, if necessary, can transfer whole blood, plasma or prothrombin complex.
5.Because this product is an indirect anticoagulant, the half-life is long, and the effect can be stabilized after 5-7 days of administration. Therefore, it is necessary to observe the 5-7 days after the dose is sufficient.

Pregnant women and lactating women:
1. Easy to pass through the placenta and cause teratogenicity. The use of this product during pregnancy can cause "fetal warfarin syndrome", the incidence rate can reach 5% to 30%. It is characterized by osteophyte separation, nasal hypoplasia, optic atrophy, mental retardation, heart, liver, spleen, gastrointestinal tract, head and other deformities. Application in the late pregnancy can cause bleeding and stillbirth, so this product is banned in the first 3 months of pregnancy and 3 months after the third trimester. Pregnant women with hereditary thrombophilia can be given small doses of heparin when treated with this product and undergo strict experimental monitoring.

2. A small amount of warfarin can be secreted by milk. The lactating women take 5-10 mg daily, the blood concentration is generally 0.48-1.8 μg/ml, and the drug concentration in milk and baby plasma is extremely low, which has little effect on the baby.

Pediatric medication:
The dose should be adjusted as needed by the individual.

Geriatric medication:
Older people should be used with caution and the dosage should be appropriately reduced and individualized.

Medicine interactions:
The drugs that enhance the anticoagulant effect of this product are: aspirin, sodium salicylate, glucagon, quinidine, indomethacin, phenylbutazone, quinine, uric acid, metobutamide, metronidazole, Allopurinol, erythromycin, chloramphenicol, certain aminoglycoside antibiotics, cephalosporins, benzodiazepine, cimetidine, clofibrate, dextrothyroxine, acetaminophen and the like. Drugs that reduce the anticoagulant effect of this product: phenytoin, barbiturate, oral contraceptives, estrogen, cholestyramine, rifampicin, vitamin K, chlorthalidone, spironolactone, acetonide, corticosteroids, etc. Drugs that cannot be combined with this product: adrenaline hydrochloride, amikacin, vitamin B12, m-hydroxylamine, oxytocin, chlorpromazine hydrochloride, vancomycin hydrochloride, etc. This product is combined with chloral hydrate, its efficacy and toxicity are enhanced, and should be used with caution. The absorption barrier or decreased synthesis of vitamin K also affects the anticoagulant effect of this product.

Pharmacological effects:
Pharmacological action
This product is a double-coumarin intermediate-effect anticoagulant. Its mechanism of action is competitive anti-vitamin K, inhibits the synthesis of coagulation factors in hepatocytes, and also has the effect of reducing thrombin-induced platelet aggregation, and thus has anticoagulant and anti-platelet aggregation functions.

Toxicology
This experiment was not performed and there is no reliable reference.

Overdose:
This experiment was not performed and there is no reliable reference.


Pharmacokinetics:
Oral gastrointestinal absorption is rapid and complete, with bioavailability as high as 100%. After absorption, the binding rate to plasma protein is 98% to 99%, which can pass through the placenta, and there is very little in breast milk. It is mainly accumulated in the lungs, liver, spleen and kidneys. Metabolized by the liver, metabolites are excreted by the kidneys. 12 to 18 hours after taking the drug, 36 to 48 hours to reach the peak of anticoagulation, maintained for 3 to 6 days, t1/2 about 37 hours.

DRUG INTERACTIONS
If use with the other drugs at the same time may occur drug interactions,details please consult your physician or pharmacist.

VALIDITY
24 months.

STORAGE
Preserve in tightly closed containers,stored in a cool and dry place.

APPROVAL NUMBER
State medical permitment number.H31022123.

Manufactured
SHANGHAI YAOXINYI PHARMACEUTICAL CO.,LTD

Tips: part of the goods frequent replacement of packaging, such as goods and pictures are not exactly the same, please refer to the goods you receive.

General Cautions
Keep away from animals and children.

This product has not been evaluated by the FDA. It is not intended to
diagnose, treat, cure, or prevent any disease.
We highly recommend that you consult with a Traditional Chinese Medical
practitioner or physician before taking any products or if you have any questions regarding your health.