Coumadin

What Coumadin is and what it is used for

Brintellix contains the active substance vortioxetine. It belongs to a group of medicines called antidepressants and you have been given this medicine to treat your depression. Brintellix has been shown to reduce the broad range of depressive symptoms, including sadness, inner tension (feeling anxious), sleep disturbances (reduced sleep), reduced appetite, difficulty in concentrating, feelings of worthlessness, loss of interest in favourite activities, feeling of being slowed down. Brintellix is used to treat major depressive episodes in adults.

How to take Coumadin

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure. Your dose will be decided by your doctor and will depend on the results of the blood tests carried out to measure the time it takes your blood to clot. Once you have been stabilised on this medicine the usual dose is between 3
•9 mg. Try to take the medicine at the same time each day. The score line is not intended for breaking the tablet. If you take more Warfarin 0.5mg Tablets than you should: Talk to your doctor or go to your nearest hospital casualty department straight away. Take the medicine pack with you. Symptoms of taking too much Warfarin Tablets include bleeding, black tarry stools, blood in urine, heavy bleeding or oozing from cuts and wounds or unusually heavy menstrual bleeding. If you forget to take Warfarin 0.5mg Tablets: If you usually take your Warfarin Tablets in the evening and you have forgotten to take it, if you remember before midnight on the same day, take the missed dose. If midnight has passed do not take that dose. Make a note that you have missed a dose and take your normal dose the next day at the usual time. If you usually take your Warfarin Tablets in the morning and have forgotten to take it the general advice is as follows:
• if it is less than two hours late, take the dose as soon as you remember and then continue as normal.
• if it is more than two hours late, take the dose as soon as you remember and then continue as normal. However, if it is time to take your next dose leave out the missed dose. Never take a double dose to catch up. Make a note that you have missed a dose. If you are not sure what to do if you have missed a dose ask your GP or anticoagulant clinic for advice.

Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them. Do not be concerned about this list of side effects. You may not get any of them, but it is important to know what to do if they occur. Stop taking Warfarin and go to hospital at once if you have:
• a rare allergic reaction such as swelling of the face, tongue, lips and throat, difficulty breathing, severe itching of your skin with raised lumps. You may need urgent medical attention. Tell your doctor straight away if you have any of the following side effects:

The following side effects have also been reported but their frequency is not known:
• any unexpected bleeding or signs of bleeding (as this could mean that your clotting levels are too low and that your dose needs to be adjusted);
•unexplained nose bleeds, bleeding gums
•unexplained bruising or pinpoint red spots on your skin
•heavy bleeding or oozing from cuts and wounds
•pink, dark red or brown urine (this may be due to bleeding in the bladder or kidneys)
•black tarry stools, vomiting blood or particles that look like coffee grounds (signs of bleeding in the stomach or intestines), bleeding from the back passage (rectum)
•coughing up blood
•(in women) unusually heavy periods or bleeding from the vagina
•blurred vision, slurred speech, loss of movement, numbness, dizziness, headache, feeling or being sick, fits, loss of consciousness, these could be a sign of a bleed in the brain.
• painful, blue-purple coloured toes
• yellowing of the skin and white of eyes (jaundice)
• severe pain in the upper abdomen (a sign of inflammation of the pancreas)
• a painful skin rash. On rare occasions warfarin can cause serious skin conditions, including one called calciphylaxis that can start with a painful skin rash but can lead to other serious complications. This adverse reaction occurs more frequently in patients with chronic kidney disease. Tell your doctor or pharmacist if any of the following side effects persist, get worse or if you notice any other side effects not listed:
• feeling sick or being sick, diarrhoea
• hair loss
• skin rash
• fever
• drop in number of red blood cells, blood haemoglobin (shown in blood tests).

Reporting of side effects If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine.

How to Store Coumadin