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warfarin

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Brand names: Coumadin, Jantoven

Vitamin K Antagonist (Anticoagulant) Rx

Warfarin is a medicine that helps prevent blood clots. It is used to treat and prevent dangerous clots from forming in your body.

Drug Pricing (NADAC)

Generic Price

$0.09/unit

Generic Available

Yes (5 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

Warfarin is used to prevent and treat blood clots in your veins and lungs.

Common side effects

Bleeding from any tissue or organ

Key warnings

Warfarin can cause major or fatal bleeding.

How It Works

Warfarin works by blocking your body's use of vitamin K. Vitamin K is needed to make blood clotting factors. By blocking vitamin K, warfarin makes your blood less likely to clot.

How to Take It

Take warfarin exactly as your doctor tells you. Your doctor will adjust your dose based on regular blood tests (INR). The goal is to keep your INR in the right range. Follow your doctor's instructions carefully and do not change the dose yourself.

Pregnancy & Breastfeeding

Warfarin can harm your unborn baby, especially during the first three months of pregnancy. Do not take warfarin if you are pregnant, unless you have a mechanical heart valve and your doctor says the benefits outweigh the risks. Talk to your doctor if you are breastfeeding, and watch your baby for bruising or bleeding.

Missed Dose

If you miss a dose of warfarin, take it as soon as you remember, unless it is almost time for your next dose. Do not take two doses at once.

Storage

Store warfarin at room temperature (68° to 77°F) in a tightly closed container, away from light.

Side Effects (from patient reports)

Based on 62,747 FDA adverse event reports.

INR increased
10,275
Shortness of breath
8,408
Interaction with another medicine
6,289
Tiredness
6,141
Feeling sick to your stomach
5,921
Loose stools
5,909
Feeling lightheaded
5,166
Medicine not working
5,113
Accidental fall
4,807
Death
4,718

FDA Adverse Event Report Analysis

Detailed analysis of 124,873 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 1999–2025.

Total Reports

124,873

Death-Related Reports

15,949

Hospitalization Reports

57,230

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 56,289 (49%)
Male 57,543 (50%)

Age Distribution

0–17 1,412
18–44 7,210
45–64 23,771
65–74 23,936
75+ 32,010

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 INTERNATIONAL NORMALISED RATIO INCREASED 10,276
2 DYSPNOEA 8,408
3 DRUG INTERACTION 6,288
4 FATIGUE 6,143
5 NAUSEA 5,921
6 DIARRHOEA 5,909
7 DIZZINESS 5,166
8 DRUG INEFFECTIVE 5,113
9 FALL 4,809
10 DEATH 4,718
11 HEADACHE 4,651
12 ASTHENIA 4,369
13 PNEUMONIA 4,097
14 HAEMORRHAGE 4,036
15 ANAEMIA 3,928

Reactions in Death Reports

DEATH 4,705
DYSPNOEA 1,178
PNEUMONIA 1,052
SEPSIS 950
INTERNATIONAL NORMALISED RATIO INCREASED 885
NAUSEA 834
FALL 764
HYPOTENSION 735
CARDIAC ARREST 725
VOMITING 690

Reactions in Hospitalization Reports

INTERNATIONAL NORMALISED RATIO INCREASED 6,599
DYSPNOEA 5,185
PNEUMONIA 3,342
FALL 3,308
DRUG INTERACTION 3,237
ANAEMIA 2,957
NAUSEA 2,832
DIARRHOEA 2,733
ASTHENIA 2,678
FATIGUE 2,509

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

Warfarin can cause major or fatal bleeding. You must have your blood tested regularly (INR) while taking warfarin. Many things, like other medicines and diet changes, can affect your INR. Tell your doctor about any bleeding and follow their instructions to prevent bleeding.

Known Drug Interactions

NSAIDs, Aspirin, Warfarin): May potentiate the risk of bleeding ( 7.4 ) Drugs Tightly Bound to Plasma Proteins: May cause a shift in plasma concentrations ( 7.6 , 7.7 ) Olanzapine: When used in combination with fluoxetine, also refer to the Drug Interactions section of the package insert for Symbyax ( 7.7 ) Drugs that Prolong the QT Interval: Do not use fluoxetine with thioridazine or pimozide. 7.4 Drugs that Interfere with Hemostasis (e.g., NSAIDs, Aspirin, Warfarin) Serotonin release by platelets plays an important role in hemostasis. Altered anticoagulant effects, including increased ble...

Mechanism: Fluoxetine can change how your blood thinner works and affect how your blood clots, making it more likely for you to bleed.

What to do: Your doctor will need to monitor your blood clotting levels very closely and may need to adjust your warfarin dose.

( 7.1 ) Warfarin: Do not use in patients taking tamoxifen for DCIS and for reduction in breast cancer incidence in women at high risk. Warfarin A marked increase in anticoagulant effect may occur when tamoxifen is used in combination with warfarin. Closely monitor coagulation indices in patients who are taking tamoxifen for either the treatment of metastatic breast cancer or as adjuvant therapy who require concomitant use of warfarin [see Contraindications (4) ] .

Mechanism: Tamoxifen increases the blood-thinning effects of warfarin, which can lead to a much higher risk of dangerous bleeding.

What to do: Avoid using these together if you are taking tamoxifen for cancer prevention, or have your doctor check your blood clotting levels very often.

moderate ibuprofen

Table 3: Drugs that Can Increase the Risk of Bleeding Drug Class Specific Drugs Anticoagulants argatroban, dabigatran, bivalirudin, desirudin, heparin, lepirudin Antiplatelet Agents aspirin, cilostazol, clopidogrel, dipyridamole, prasugrel, ticlopidine Non-steroidal Anti-Inflammatory Agents celecoxib, diclofenac, diflunisal, fenoprofen, ibuprofen, indomethacin, ketoprofen, ketorolac, mefenamic acid, naproxen, oxaprozin, piroxicam, sulindac Serotonin Reuptake Inhibitors citalopram, desvenlafaxine, duloxetine, escitalopram, fluoxetine, fluvoxamine, milnacipran, paroxetine, sertraline, venlafa...

Mechanism: Ibuprofen is an anti-inflammatory drug that increases the risk of bleeding when taken with warfarin. Both medications interfere with the body's natural ability to form blood clots.

What to do: Your doctor should monitor you closely for signs of bleeding, such as unusual bruising. Report any dark or bloody stools to your healthcare provider immediately.

moderate aspirin

Table 3: Drugs that Can Increase the Risk of Bleeding Drug Class Specific Drugs Anticoagulants argatroban, dabigatran, bivalirudin, desirudin, heparin, lepirudin Antiplatelet Agents aspirin, cilostazol, clopidogrel, dipyridamole, prasugrel, ticlopidine Non-steroidal Anti-Inflammatory Agents celecoxib, diclofenac, diflunisal, fenoprofen, ibuprofen, indomethacin, ketoprofen, ketorolac, mefenamic acid, naproxen, oxaprozin, piroxicam, sulindac Serotonin Reuptake Inhibitors citalopram, desvenlafaxine, duloxetine, escitalopram, fluoxetine, fluvoxamine, milnacipran, paroxetine, sertraline, venlafa...

Mechanism: Aspirin is an antiplatelet drug that adds to the blood-thinning effect of warfarin. Taking both together significantly increases your chance of having a serious bleeding event.

What to do: Talk to your doctor before taking these two drugs together. They may need to adjust your dosage or check your blood levels more frequently.

moderate diclofenac

Table 3: Drugs that Can Increase the Risk of Bleeding Drug Class Specific Drugs Anticoagulants argatroban, dabigatran, bivalirudin, desirudin, heparin, lepirudin Antiplatelet Agents aspirin, cilostazol, clopidogrel, dipyridamole, prasugrel, ticlopidine Non-steroidal Anti-Inflammatory Agents celecoxib, diclofenac, diflunisal, fenoprofen, ibuprofen, indomethacin, ketoprofen, ketorolac, mefenamic acid, naproxen, oxaprozin, piroxicam, sulindac Serotonin Reuptake Inhibitors citalopram, desvenlafaxine, duloxetine, escitalopram, fluoxetine, fluvoxamine, milnacipran, paroxetine, sertraline, venlafa...

Mechanism: Diclofenac is an anti-inflammatory medicine that can increase the risk of bleeding when used with warfarin. This combination makes it harder for your blood to clot properly.

What to do: Avoid using these medications together unless your doctor specifically tells you to. If you must take both, watch closely for any signs of bleeding or bruising.

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Common Questions

What is INR?
INR stands for International Normalized Ratio. It is a blood test that measures how long it takes your blood to clot.
How often will I need blood tests?
You will need daily INR tests when you first start warfarin. Once your INR is stable, you will need tests every 1 to 4 weeks.
What should I do if I start a new medicine?
Tell your doctor about all medicines you take, including over-the-counter drugs and herbal products. Starting or stopping any medicine can affect your INR.
Can I eat whatever I want while taking warfarin?
Keep your diet consistent, especially with foods high in vitamin K, like leafy green vegetables. Sudden changes in your diet can affect your INR.
What are the signs of bleeding?
Signs of bleeding include unusual bruising, nosebleeds, bleeding gums, blood in your urine or stool, heavy menstrual periods, and coughing up blood.
What should I do if I have a minor cut?
For minor cuts, apply pressure until the bleeding stops. Tell your doctor if the bleeding is heavy or does not stop.
Can I drink alcohol while taking warfarin?
Talk to your doctor about drinking alcohol. Alcohol can affect your INR.
What if I need surgery or a dental procedure?
Tell your doctor and dentist that you are taking warfarin. You may need to stop taking warfarin a few days before the procedure.
Can I take aspirin or ibuprofen for pain?
Talk to your doctor before taking aspirin or ibuprofen. These medicines can increase your risk of bleeding.
What should I do if I fall or hit my head?
See a doctor right away, even if you feel fine. A head injury can cause bleeding in the brain.
What are the common side effects of warfarin?
The most commonly reported side effects of warfarin include Bleeding from any tissue or organ. Based on 62,747 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does warfarin interact with other medications?
Yes, warfarin has 163 known drug interactions. Notable interactions include fluoxetine, tamoxifen, ibuprofen. Always inform your doctor about all medications you are taking.
What drug class is warfarin?
warfarin belongs to the Vitamin K Antagonist (Anticoagulant) drug class. It requires a prescription (Rx). Warfarin is used to prevent and treat blood clots in your veins and lungs.
Is warfarin safe during pregnancy?
Warfarin can harm your unborn baby, especially during the first three months of pregnancy. Do not take warfarin if you are pregnant, unless you have a mechanical heart valve and your doctor says the benefits outweigh the risks. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.

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Medication Guides

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What the FDA Data Shows for warfarin

The FDA label for warfarin (sold under brand names such as Coumadin, Jantoven) classifies it as a prescription-only medication in the Vitamin K Antagonist (Anticoagulant) class. Warfarin is used to prevent and treat blood clots in your veins and lungs. Official labeling lists 1 commonly reported side effect, including Bleeding from any tissue or organ.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 62,747 voluntary reports. The database also lists 163 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $0.09.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: June 17, 2025

All federal data sources used on this page