does anybody out there know about warfarin- the anticoagulation therapy drug?

Question

if someone had a stroke and they were put on a normal dose of warfarin, do you think it would be safe for them to take a ginseng supplement (to improve momory), if not, what would you advise them to do

Answer 1

ask a pharmascist. they know how drugs and herbs (for the most part) will interact.

Answer 2

I used to take warfarin before. When u are on warfarin, u should avoid taking vitamin K that is found mostly in GREEN vegetable. U can eat green vegetable but not to much. U can take a ginseng supplement but consult your physician first. There are some ginseng that can be taken and some are not likely to be taken.

Answer 3

Originally formulated in wis. to kill rats on the farm. They would consume some and bleed to death. Warfarin is the generic name for trade name coumadin, It's been very effectively used for over 40 years. There would be no problem in using ginseng with it, the only problem is obtaining good ginseng. Try to get either korean or wisconsin grown.

Answer 4

It should be safe enough, but you should discuss the matter with your treating doctor first.

What should happen is that your doctor will monitor the warfarin effect (with the blood INR test) and if it goes up or down, the doctor could then adjust the warfarin dose.

Answer 5

This a question for the doctor or your pharmacist. There are some naturals remedies that can effect the clotting time and can be dangerous if taken while on warfarin.

Answer 6

Warfarin comes 1mg,2,21/2,3,4,5,6,7.5 and 10mg this drug is use to thin the blood.And with this drug u should ask the doctor before trying anything.Once u start taking it u will be on the rest of your life more likely.

Answer 7

I would advise you to ask your doctor if there is any contra indication of using the ginseng with the anticoagulation therapy to be safe.

Answer 8

Goto your local book store hastings etc and look in the health section under nursing look up nursing drug guide there are several find the one that mentions herbal and drug interactions and LOOK IT UP. I wouldnt recommend mixing the two.

Answer 9

ask the pharmacist or the doctor to see if the are contraindicated

Answer 10

I hope u get everything here. Just check this

Warfarin (also known under the brand names of Coumadin®, Jantoven®, Marevan®, and Waran®) is an anticoagulant medication that is administered orally or, very rarely, by injection. It is used for the prophylaxis of thrombosis and embolism in many disorders. Its activity has to be monitored by frequent blood testing for the international normalized ratio (INR). It is named for the Wisconsin Alumni Research Foundation.

Warfarin is a synthetic derivative of coumarin, a chemical found naturally in many plants, notably woodruff (Galium odoratum, Rubiaceae), and at lower levels in licorice, lavender and various other species. Warfarin was originally developed as a rat poison, but it is no longer used for that purpose as modern poisons are much more potent and toxic (e.g. brodifacoum). However, warfarin and contemporary rodenticides belong to the same class of drugs (coumarins) and both decrease blood coagulation by interfering with vitamin K metabolism.

Mechanism of action
Warfarin inhibits the effective synthesis of biologically active forms of the vitamin K-dependent clotting factors: II, VII, IX and X, as well as the regulatory factors protein C, protein S and protein Z. Other proteins not involved in blood clotting, such as osteocalcin, may also be affected.

The precursors of these factors require carboxylation of their glutamic acid residues to allow the coagulation factors to bind to phospholipid surfaces. This carboxylation is linked to oxidation of vitamin K to form vitamin K epoxide, which is in turn recycled back to the reduced form by the enzyme vitamin K epoxide reductase (VKOR). Warfarin inhibits epoxide reductase[1] (specifically the VKORC1 subunit[2][3]), thereby diminishing available vitamin K stores and inhibiting production of functioning coagulation factors. As the body stores of previously-produced factors degrade (over several days), the anticoagulation effect becomes apparent. The coagulation factors are produced, but have decreased functionality due to undercarboxylation; they are collectively referred to as PIVKAs (proteins induced [by] vitamin K absence/antagonism).

Uses

Medical use
Warfarin is prescribed to people with an increased tendency for thrombosis or as prophylaxis in those individuals who have already formed a blood clot (thrombus) which required treatment. This can help prevent formation of future blood clots and help reduce the risk of embolism (migration of a thrombus to a spot where it blocks blood supply to a vital organ). Common clinical indications for warfarin use are atrial fibrillation, artificial heart valves, deep venous thrombosis and pulmonary embolism.[4]

Dosing of warfarin is complicated by the fact that it is known to interact with many commonly used medications and other chemicals that may be present in appreciable quantities in food. These interactions may enhance or reduce warfarin's anticoagulation effect. Many commonly used antibiotics, such as metronidazole or the macrolides, will greatly increase the effect of warfarin by reducing the metabolism of warfarin in the body. Other broad-spectrum antibiotics can reduce the amount of the normal bacterial flora in the bowel, which make significant quantities of Vitamin K, thus potentiating the effect of warfarin. In addition, food that contains large quantities of Vitamin K will reduce the warfarin effect; and medical conditions such as hypo- or hyperthyroidism will alter the rate of breakdown of the clotting factors.

Therefore, in order to optimise the therapeutic effect without risking dangerous side effects, such as bleeding, close monitoring of the degree of anticoagulation is required by blood testing (INR) . Initially, checking may be as often as twice a week; the intervals can be lengthened if the patient manages stable therapeutic INR levels on an unchanged warfarin dose.

When initiating warfarin therapy ("warfarinisation"), the doctor will decide how strong the anticoagulant therapy needs to be. The target INR level will vary from case to case dependent upon the clinical indicators, but tends to be 2-3 in most conditions.

The oral anticoagulant ximelagatran (Exanta®) was expected to replace warfarin to a large degree when introduced; however, reports of hepatotoxicity (liver damage) prompted its manufacturer to withdraw it from further development. Other drugs offering the efficacy of warfarin without a need for monitoring, such as dabigatran and rivaroxaban, are under development.

Side-effects
The only common side-effect of warfarin is hemorrhage (bleeding). The risk of severe bleeding is small but definite (1-2% annually) and any benefit needs to outweigh this risk when warfarin is considered as a therapeutic measure. Risk of bleeding is augmented if the INR is out of range (due to accidental or deliberate overdose or due to interactions), and may cause hemoptysis (coughing up blood), excessive bruising, bleeding from nose or gums, or blood in urine or stool.

A feared (but rare) complication of warfarin is warfarin necrosis, which occurs more frequently shortly after commencing treatment in patients with a deficiency of protein C. Protein C is an innate anticoagulant that, like the procoagulant factors that warfarin inhibits, requires vitamin K-dependent carboxylation for its activity. Since warfarin initially decreases protein C levels faster than the coagulation factors, it can paradoxically increase the blood's tendency to coagulate when treatment is first begun (many patients when starting on warfarin are given heparin in parallel to combat this), leading to massive thrombosis with skin necrosis and gangrene of limbs. Its natural counterpart, purpura fulminans, occurs in children who are homozygous for protein C mutations.

Warfarin is slower acting than the common anticoagulant heparin, though it has a number of advantages. Heparin must be given by injection, while warfarin is available orally. Warfarin has a long half-life and need only be given once a day. Heparin can also cause a prothrombotic condition, heparin-induced thrombocytopenia (an antibody-mediated decrease in platelet levels), which paradoxically increases the risk for thrombosis. Warfarin's long half life, on the other hand, means it often takes several days to reach therapeutic effect. Furthermore, if given initially without additional anticoagulant cover, it can paradoxically increase thrombosis risk. For these main reasons, hospitalised patients are usually given heparin initially, and are then moved on to warfarin.

Warfarin can be reversed with vitamin K, or for rapid reversal (e.g. in case of severe bleeding), with fresh frozen plasma but this treatment is being replaced by use of prothrombin complex concentrate.


Interactions and contraindications
There are many drug-drug interactions with warfarin, and its metabolism varies greatly between patients. Some foodstuffs have also been reported to interact with warfarin[8] This makes finding the correct dosage difficult, and accentuates the need of monitoring; when initiating a medication that is known to interact with warfarin (e.g. amiodarone), INR checks are increased or dosages adjusted until a new ideal dosage is found.

Warfarin cannot be given to pregnant women, especially in the first trimester, as it is a teratogen (it causes deformations of the face and bones). During the third trimester, antepartum hemorrhage can occur. Instead of warfarin, low molecular weight heparin is generally used.

Excessive use of alcohol is also known to affect the metabolism of warfarin, although moderate drinking usually has little or no effect on the INR value. Patients suffering from liver damage or alcoholism are usually treated with heparin injections instead.

Warfarin also interacts with the following herbs: [9]

Ginkgo (a.k.a. Ginkgo Biloba), which is commonly used to increase brain blood flow, prevent dementia, and improve memory. However, ginkgo may increase blood pressure, and may increase bleeding, especially in people already taking certain anti-clotting medications such as warfarin.


Ginseng is commonly used to help with fatigue and weakness. However, ginseng may increase blood pressure and heart rate and may increase bleeding, especially in people already taking certain anti-clotting medications such as warfarin.

It will be better for ur patient to b on Neurobion/ Polybion