Unifarin 1

Introduction
Unifarin 1 is an oral anticoagulant which helps prevent the formation of harmful blood clots in the legs, lungs, brain and heart. It is used for deep vein thrombosis, pulmonary embolism and stroke prevention. Unifarin 1 should be taken as advised by the doctor. You may take it with or without food but it is better to take it at a fixed time. This medicine should not be stopped abruptly without consulting the doctor. You should take this medicine regularly to get the most benefit, even if you feel fine. It is preventing future harm. Use of this medicine may increase your risk of bleeding. Let your doctor know immediately if you see pinpoint rash or blood in your vomits, urine, or stool. If you are going under any surgery or dental treatment then you may need to stop this medicine for some time but only after consulting with your doctor. Before taking it, you must inform doctor if you are suffering from any kidney or liver disease. Also let your doctor know if you are pregnant or breastfeeding and about all the other medications that you are taking regularly.

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Uses of Unifarin 1
Deep vein thrombosis
Pulmonary embolism
Stroke prevention
How to use Unifarin 1
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Unifarin 1 may be taken with or without food, but it is better to take it at a fixed time. Avoid Unifarin 1 with Vitamin K rich food such as spinach, collards, broccoli, spring onions, cucumber and dried basil.
How Unifarin 1 works
Unifarin 1 is an anticoagulant. It works by preventing the formation of harmful blood clots. Although it does not dissolve the existing blood clots, it prevents them from growing larger and causing blockages in the blood vessels.
What if you forget to take Unifarin 1?
If you miss a dose of Unifarin 1, skip it and continue with your normal schedule. Do not double the dose.
Quick Tips
Avoid making sudden major changes to your diet during treatment with this medicine.
Do not consume alcohol while taking Unifarin 1 as this may increase its side effects.
If you are going to have a surgery or dental treatment, you may be asked to stop taking Unifarin 1 temporarily.
Do not discontinue use without consulting your doctor as this may increase your chances of having another heart attack or stroke.
Brief Description
Indication
Venous thromboembolism, Stroke prevention, Deep vein thrombosis
Administration
May be taken with or without food.
Adult Dose
Oral Treatment and prophylaxis of venous thromboembolism, Stroke & Thromboembolism, Post-Myocardial Infarction Adult: Initially, 2-5 mg qDay for 2 days, OR 10 mg daily for 2 days in healthy individuals Initiate warfarin on day 1 or 2 of LMWH or unfractionated heparin therapy and overlap until desired INR, THEN discontinue heparin Check INR after 2 days and adjust dose according to results Usual maintenance dose: 2-10 mg daily. Elderly: Anticoagulation Lower doses required to produce therapeutic level of anticoagulation Initial: <5 mg PO qDay Maintenance: 2-5 mg PO qDay Hepatic impairment: Severe: Avoid. _ Child Dose Thrombosis Prevention/treatment: If baseline INR is 1.0-1.3, administer loading dose of 0.1-0.2 mg/kg PO qDay × 1 day; check INR on days 2-4 and adjust daily dose to maintain INR between 2.0 and 3.0 (unless valve replacement indicates a higher range) Use 0.1 mg/kg to initiate therapy with liver impairment or in patients who have had a Fontan procedure Typical maintenance dose: 0.09-0.33 mg/kg/day, with infants <12 months old often requiring doses at high end of range _ Contraindication Patient w/ haemorrhagic tendencies or blood dyscrasias, recent or contemplated surgery of the CNS or eye, those undergoing traumatic surgery resulting in large open surfaces, overt bleeding or active ulceration involving the GI, genitourinary or resp tract, cerebrovascular haemorrhage, cerebral aneurysms, dissecting aorta, pericarditis and pericardial effusions, bacterial endocarditis, threatened abortion, eclampsia, pre-eclampsia, malignant HTN. Unsupervised patients w/ conditions associated w/ potential high level of non-compliance, spinal puncture and other diagnostic or therapeutic procedures w/ potential for uncontrolled bleeding, major regional or lumbar block anaesth. Concomitant use w/ fibrinolytic drugs (e.g. streptokinase, alteplase). Pregnancy. Mode of Action Warfarin inhibits synthesis of vit K-dependent coagulation factors VII, IX, X and II and anticoagulant protein C and its cofactor protein S. No effects on established thrombus but further extension of the clot can be prevented. Secondary embolic phenomena are avoided. Precaution Any condition where added risk of haemorrhage, necrosis and/or gangrene is present. Patient w/ heparin-induced thrombocytopenia, infectious diseases or disturbances of intestinal flora (e.g. sprue), indwelling catheters, moderate to severe HTN, vit C or K deficiency, known or suspected deficiency in protein C-mediated anticoagulant response, polycythemia vera, vasculitis, DM. Moderate to severe hepatic or renal impairment. Elderly. Lactation. Patient Counselling Eat a balanced diet w/ a constant amount of vit K. Avoid ingestion of large quantities of certain foods that contain a large amount of vit K (e.g. leafy green vegetables, certain vegetable oils), drastic changes in diet and activities or sports that could cause traumatic injury. Monitoring Parameters Monitor prothrombin time, haematocrit, INR (frequency varies depending on INR stability); may consider genotyping of CYP2C9 and VKORC1 prior to initiation of therapy, if available. Lactation: Not excreted in breast milk as reported in limited published study (AAP Committee states compatible with nursing); because of potential for serious adverse reactions, including bleeding in breastfed infant, consider developmental and health benefits of breastfeeding along with mother’s clinical need for therapy; monitor breastfeeding infants for bruising or bleeding _ Side Effect Hemorrhage is the principal adverse effect of oral anticoagulants. Jaundice, hepatic dysfunction, vasculitis, pancreatitis, nausea, vomiting, diarrhoea, taste perversion, abdominal pain, flatulence, bloating, rash, purpura, erythematous swollen skin patches leading to ecchymosis, pruritus, alopecia, purple discolouration of toes due to cholesterol embolisation, tracheal or tracheobronchial calcification, fever, chills. Unexplained drop in haematocrit, decreased Hb. Rarely, hypersensitivity reactions. Potentially Fatal: Haemorrhage from almost any organ of the body w/ the consequent effects of haematomas as well as anaemia, tissue necrosis and/or gangrene of skin or other tissues w/ SC infarction. _ Interaction Cholestatic hepatitis may occur when taken concomitantly w/ ticlopidine. Increased risk of bleeding w/ other anticoagulants (e.g. argatroban, dabigatran, heparin), antiplatelet agents (e.g. aspirin, cilostazol, clopidogrel), NSAIDs (e.g. celecoxib, diclofenac, ibuprofen), serotonin reuptake inhibitors (e.g. citalopram, paroxetine, venlafaxine). Increased INR w/ CYP2C9 (e.g. amiodarone, capecitabine, cotrimoxazole), CYP1A2 (e.g. aciclovir, allopurinol, ciprofloxacin) and CYP3A4 (e.g. alprazolam, amlodipine, atorvastatin) inhibitors. Decreased INR w/ CYP2C9, CYP1A2 and CYP3A4 inducers. Potentially Fatal: Increased risk of bleeding w/ fibrinolytic drugs (e.g. streptokinase and alteplase). _