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עמוד הבית / קומדין 6 מ"ג / מידע מעלון לרופא

קומדין 6 מ"ג COUMADIN 6 MG (WARFARIN SODIUM)

תרופה במרשם תרופה בסל נרקוטיקה ציטוטוקסיקה

צורת מתן:

פומי : PER OS

צורת מינון:

טבליה : TABLETS

Overdose : מינון יתר

4.9 Overdose
The benefit of gastric decontamination is uncertain. If the patient presents within 1 hour of ingestion of more than 0.25 mg/kg or more than the patient's therapeutic dose, consider activated charcoal (50 g for adults; 1 g/kg for children)

In cases of life-threatening haemorrhage
Stop warfarin treatment, give prothrombin complex concentrate (factors II, VII, IX, and X) 30– 50 units/kg or (if no concentrate available) fresh frozen plasma 15 mL/kg. Discuss with local haematologist or National Poisons Information Service, or both.

Non-life threatening haemorrhage
Where anticoagulation can be suspended, give slow intravenous injection of phytomenadione (vitamin K1) 10–20 mg for adults (250 micrograms/kg for a child)
Where rapid re-anticoagulation is desirable (e.g., valve replacements) give prothrombin complex concentrate (factors II, VII, IX, and X) 30–50 units/kg or (if no concentrate available) fresh frozen plasma 15 mL/kg.
Monitor INR to determine when to restart normal therapy. Monitor INR for at least 48 hours post overdose.

For patients on long-term warfarin therapy without major haemorrhage
• INR >8.0, no bleeding or minor bleeding—stop warfarin, and give phytomenadione (vitamin K1) 0.5–1 mg for adults, 0.015– 0.030 mg/kg (15–30 micrograms/kg) for children by slow intravenous injection or 5 mg by mouth (for partial reversal of anticoagulation give smaller oral doses of phytomenadione e.g., 0.5–2.5 mg using the intravenous preparation orally); repeat dose of phytomenadione if INR still too high after 24 hours. Large doses of phytomenadione may completely reverse the effects of warfarin and make re-establishment of anticoagulation difficult.
• INR 6.0–8.0, no bleeding or minor bleeding—stop warfarin, restart when INR <5.0
• INR <6.0 but more than 0.5 units above target value—reduce dose or stop warfarin, restart when INR <5.0


For patients NOT on long-term anticoagulants without major haemorrhage Measure the INR (prothrombin time) at presentation and sequentially every 24–48 hours after ingestion depending on the initial dose and initial INR.
• If the INR remains normal for 24–48 hours and there is no evidence of bleeding, there should be no further monitoring necessary.
• Give vitamin K1 (phytomenadione) if: a) There is no active bleeding and the patient has ingested more than 0.25 mg/kg; OR
b )The prothrombin time is already significantly prolonged (INR >4.0).
The adult dose of vitamin K1 is 10–20 mg orally (250 micrograms/kg body weight for a child).
Delay oral vitamin K1 at least 4 hours after any activated charcoal has been given. Repeat INR at 24 hours and consider further vitamin K1.

שימוש לפי פנקס קופ''ח כללית 1994 Deep vein thrombosis, atrial fibrillation with embolism, cardiac valve prostheses
תאריך הכללה מקורי בסל 01/01/1995
הגבלות תרופה שאושרה לשימוש כללי בקופ'ח

רישום

111 49 29379 00

מחיר

0 ₪

מידע נוסף

עלון מידע לרופא

16.08.20 - עלון לרופא

עלון מידע לצרכן

16.08.20 - החמרה לעלון

לתרופה במאגר משרד הבריאות

קומדין 6 מ"ג

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