藥碼
MAF01
藥名
Warfarin 錠 5 mg
英文商品名
Mafarin 錠劑 5 mg
中文商品名
脈化寧錠 5 毫克
螢幕名
Mafarin 錠劑 5 mg
劑型
Tab
規格
成分
藥理分類
Anticoagulants
健保碼
AC50095100
ATC碼
藥品圖片
外觀圖片
適應症
【藥品性質提示】
根據 2019 AGS Beers Criteria,本藥品為【潛在不適當用藥 (PIM)】,不建議老年人併用以下藥品使用,會增加出血風險:Amiodarone、Ciprofloxacin、Macrolides、TMP/SMX、NSAID

#高警訊藥品

抗凝血口服
Myocardial infarction: Adjunct to reduce risk of systemic embolism (eg, myocardial infarction, stroke) after myocardial infarction
Thromboembolic complications: Prophylaxis and treatment of thromboembolic disorders (eg, venous, pulmonary) and embolic complications arising from atrial fibrillation or cardiac valve replacement
藥理
Anticoagulant, Vitamin K Antagonist
Warfarin competitively inhibits the subunit 1 of the multi-unit VKOR complex, thus depleting functional vitamin K reserves and hence reduces synthesis of active clotting factors.
藥動學
Absorption: Completely absorbed orally
Protein binding: approximately 99%
Metabolism: CYP450 CYP2C9, CYP2C19, CYP2C8, CYP2C18, CYP1A2, CYP3A4 and reductases
Excretion: Urine (92%, primarily as metabolites; minimal as unchanged drug)
Half-life elimination: 20 to 60 hours; Mean: 40 hours
禁忌症
1. Hypersensitivity to warfarin or any component of the formulation
2. Hemorrhagic tendencies
3. Recent or potential surgery of the eye or CNS
4. Threatened abortion, pregnancy (except in women with mechanical heart valves at high risk for thromboembolism)
懷孕分類
X; Use is contraindicated during pregnancy except in patients with mechanical heart valves who are at high risk for thromboembolism; use is also contraindicated in patients with threatened pregnancy loss, eclampsia, or preeclampsia.
哺乳分類
Warfarin is considered compatible with breastfeeding (ACOG 2018). The manufacturer recommends monitoring of breastfeeding infants for bruising or bleeding.
副作用
Atheromatous embolism/cholesterol embolus, calciphylaxis, Decreased bone mineral density (BMD), Hemorrhage, Skin necrosis/gangrene
劑量和給藥方法
Dosage:
1. Initial: 5 mg once a day; at least 4-6 days of warfarin therapy are required before full therapeutic effect is achieved.
2. Maintenance: 2 to 10 mg once daily
Monitor:
Regular monitoring of INR should be performed on all treated patients.
小兒調整劑量
腎功能調整劑量
  • eGFR <60 mL/minute/1.73 m2: require ~10% to 20% lower doses
  • ESRD: require ~20% lower doses
  • Intermittent hemodialysis, Peritoneal dialysis: Unlikely to be dialyzed (highly protein bound), tend to require ~20% lower doses compared to patients with normal kidney function
  • CRRT, PIRRT: Avoid use
  • 肝功能調整劑量
    Liver impairment prior to treatment initiation:
    Child-Pugh class A: No dosage adjustment necessary; adjust dose to maintain targeted INR range.
    Child-Pugh class B to C: Consider a 50% dose reduction; use with caution
    Liver impairment developing in patients already receiving warfain:
    Child-Pugh class A to C: If needed, adjust dose to maintain targeted INR range; more frequent INR monitoring may be necessary
    安定性
    藥袋資訊
    臨床用途
    抗凝血劑,預防或治療血管栓塞
    主要副作用
    腹脹、噁心嘔吐、寒顫、皮疹
    泡製方法
    儲存方式
    請置於 15-30℃ 乾燥處儲存
    注意事項
    其他說明
    藥局 Y1 | 藥庫 口E12
    藥品外觀
    顏色
    18
    形狀
    01
    剝痕
    Y
    標記1
    MF,5
    標記2
    其他
    健保藥價
    4.98
    自費價
    6.62
    仿單
    資料庫
    健保給付規定