Marevan (Warfarin Sodium)

Marevan is a vitamin K antagonist anticoagulant used to manage conditions that predispose to clot formation.

• Prevention of thromboembolic events: Reduces risk of clot formation in patients with atrial fibrillation or other risk factors.
• Deep vein thrombosis treatment: Facilitates clot resolution and prevents extension.
• Pulmonary embolism treatment: Helps dissolve existing clots and prevents recurrence.
• Stroke prevention in atrial fibrillation: Lowers incidence of ischemic stroke.
• Prophylaxis in patients with mechanical heart valves: Maintains therapeutic anticoagulation to avoid valve thrombosis.

• Warfarin Sodium inhibits the enzyme vitamin K epoxide reductase, which is essential for recycling vitamin K. This inhibition reduces the regeneration of active vitamin K, thereby decreasing the hepatic synthesis of the vitamin K‑dependent clotting factors II, VII, IX, and X. The resulting lower levels of these factors impair the coagulation cascade, providing anticoagulant effect.

Marevan may cause a range of adverse reactions, from mild bleeding tendencies to rare but serious complications.

Common Side Effects

• Minor bleeding such as gum bleeding, nosebleeds, or easy bruising.
• Bruising or hematoma at sites of minor trauma.
• Mild gastrointestinal discomfort or nausea.
• Headache.

Serious or Rare Side Effects

• Intracranial hemorrhage.
• Warfarin‑induced skin necrosis.
• Severe allergic reaction, including anaphylaxis.

Before initiating Marevan, several safety considerations should be observed.

• Dose adjustment: Individualize based on INR monitoring.
• Regular monitoring: Frequent INR checks to maintain therapeutic range.
• Avoid in pregnancy: Contraindicated due to teratogenic risk (Category X).
• Caution with liver disease: Impaired metabolism may increase anticoagulant effect.
• Drug interactions: Review concomitant medications for potentiation of bleeding.
• Store at ambient temperature: Keep below 25°C in the original pack, protect from moisture.

Marevan interacts with many medicines; some require avoidance while others need close monitoring.

Major Interactions (Avoid)

• Strong CYP2C9 inhibitors (e.g., amiodarone, fluconazole) increase warfarin levels.
• Azole antifungals (e.g., ketoconazole) heighten bleeding risk.
• Certain antibiotics (e.g., trimethoprim‑sulfamethoxazole) potentiate anticoagulation.
• NSAIDs (e.g., ibuprofen) may exacerbate bleeding.

Moderate Interactions (Monitor Closely)

• Vitamin K‑rich foods can reduce anticoagulant effect.
• Antiplatelet agents (e.g., clopidogrel) may increase bleeding tendency.
• Herbal supplements (e.g., ginkgo, St. John’s wort) may alter INR.