Blood clots in the veins or in the lungs and in people with atrial fibrillation or artificial heart valves can be treated or prevented with Coumadin. It can also be used to reduce the risk of death, repeat heart attacks, blood clots, or strokes after a heart attack. Healthcare providers may also occasionally recommend off-label Coumadin uses, such as for preventing recurrent transient ischemic attacks.
Coumadin® (warfarin sodium) is anticoagulant "blood thinner" medication used to prevent and treat blood clots. Specifically, this medication is approved for the following uses:
- Preventing or treating blood clots in the veins (such as with deep vein thrombosis)
- Preventing or treating blood clots in the lungs (pulmonary embolism)
- Preventing or treating blood clots or related problems (such as strokes) in people with atrial fibrillation or artificial heart valves
- Reducing the risk of death, repeat heart attacks, blood clots, or strokes after a heart attack.
Coumadin has advantages and disadvantages. Advantages include painless oral dosing and low cost. Disadvantages include numerous food and drug interactions, the need for frequent monitoring using blood tests, and a narrow range for both safety and effectiveness (taking too little increases the risk of blood clots; taking too much increases the risk of dangerous internal bleeding). Coumadin is difficult to dose, and the cost of monitoring must also be taken into account.
In addition, Coumadin is slow to start working. In fact, when a person first starts taking the drug, he or she may actually be at an increased risk for clots, since Coumadin first decreases certain anticoagulant proteins in the body before it starts working to prevent clots. As a result, in many cases, people will need to be on heparin (or some other form of injectable or IV anticoagulant) for a few days until Coumadin starts working.