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Avoid activities that may increase your risk of bleeding or injuryUse extra care to prevent bleeding while shaving or brushing your teethYou may still bleed more easily for several days after you stop taking Coumadin.

Select the initial dose based on the expected maintenance dosetaking into account the above factorsModify this dose based on consideration of patient-specific clinical factorsConsider lower initial and maintenance doses for elderly and/or debilitated patients and in Asian patientssee Use In Specific Populations and CLINICAL PHARMACOLOGYRoutine use of loading doses is not recommended as this practice may increase hemorrhagic and other complications and does not offer more rapid protection against clot formation.

The appropriate initial dosing of COUMADIN varies widely for different patientsNot all factors responsible for warfarin dose variability are knownand the initial dose is influenced by:

Crystalline warfarin sodium occurs as a whiteodorlesscrystalline powder that is discolored by lightIt is very soluble in waterfreely soluble in alcoholand very slightly soluble in chloroform and ether.

CYP2C9 and VKORC1 genotype informationwhen availablecan assist in selection of the initial dose of warfarinsee DOSAGE AND ADMINISTRATION

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anticoagulants blood thinners such as warfarin coumadin ; certain cholesterol lowering medications such as atorvastatin lipitor, cholestyramine amiodarone may cause other side effects.