Waf-5
Waf-5 is warfarin 5 mg tablets — the reference vitamin K antagonist. Introduced 1954; still essential for mechanical heart valves, moderate-severe mitral stenosis, and antiphospholipid syndrome where DOACs are contraindicated. Dose individualised to INR (2.0-3.0 most indications, 2.5-3.5 mechanical valves). Extensive drug and dietary interactions; CYP2C9/VKORC1 genotype-dependent sensitivity. Regular INR monitoring mandatory. Reversed by vitamin K or 4-factor PCC.
✓ Medisch beoordeeld door Morgan Ellis — Apotheekonderzoeker · 8 jaar ervaring · Laatst beoordeeld: mei 2026
⚡ Quick Answer — What is Waf-5?
Waf-5 is 5 mg warfarin tablets from a WHO-GMP certified manufacturer — vitamin K antagonist (VKA) — oral anticoagulant. Warfarin was introduced in 1954 after synthesis from dicoumarol (the rat poison compound that caused cattle haemorrhage after spoiled sweet clover consumption in 1920s Wisconsin). Named after the Wisconsin Alumni Research Foundation (WARF) that funded its development. Remains essential for mechanical heart valves, moderate-severe mitral stenosis, and patients where DOACs are contraindicated. blocks vitamin K epoxide reductase (VKORC1), preventing regeneration of reduced vitamin K required for carboxylation of clotting factors II, VII, IX, X and proteins C and S. Takes 3-5 days to reach full effect (factor II half-life ~60 hours). Dosing: Individualised to INR target (2.0-3.0 for most indications; 2.5-3.5 for mechanical valves). Starting dose 5 mg daily for 2-3 days then adjusted by INR; 2-4 mg daily typical maintenance; wide inter-individual variation driven by CYP2C9 and VKORC1 genotype plus diet. Bleeding risk: major bleeding ~3-5%/year at therapeutic INR; rises sharply with supratherapeutic INR, acute illness, and interacting drugs. Reversal with vitamin K (slow, hours), 4-factor PCC, or fresh frozen plasma (emergencies). Anticoagulant and antiplatelet selection is individualised to diagnosis, bleeding risk, renal function, and drug interactions. Specialist or family-physician supervision is standard.
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What Is Waf-5?
Waf-5 is 5 mg warfarin tablets from a WHO-GMP certified manufacturer, supplied in 30-180 tablets. Warfarin was introduced in 1954 after synthesis from dicoumarol (the rat poison compound that caused cattle haemorrhage after spoiled sweet clover consumption in 1920s Wisconsin). Named after the Wisconsin Alumni Research Foundation (WARF) that funded its development. Remains essential for mechanical heart valves, moderate-severe mitral stenosis, and patients where DOACs are contraindicated.
How Warfarin Works
Warfarin blocks vitamin K epoxide reductase (VKORC1), preventing regeneration of reduced vitamin K required for carboxylation of clotting factors II, VII, IX, X and proteins C and S. Takes 3-5 days to reach full effect (factor II half-life ~60 hours).
Approved Uses
- Mechanical heart valves — only warfarin is approved (DOACs are contraindicated)
- Moderate-severe mitral stenosis with AF — warfarin preferred
- Atriumfibrilleren — DOACs are now first-line in most markets; warfarin remains where DOACs are contraindicated (severe CKD, concurrent strong inhibitors)
- VTE treatment and secondary prevention — largely displaced by DOACs
- Antiphospholipid syndrome — warfarin still preferred (RCTs suggested DOAC inferiority)
Dosage
Individualised to INR target (2.0-3.0 for most indications; 2.5-3.5 for mechanical valves). Starting dose 5 mg daily for 2-3 days then adjusted by INR; 2-4 mg daily typical maintenance; wide inter-individual variation driven by CYP2C9 and VKORC1 genotype plus diet.
Bleeding Risk and Monitoring
Bleeding risk: major bleeding ~3-5%/year at therapeutic INR; rises sharply with supratherapeutic INR, acute illness, and interacting drugs. Reversal with vitamin K (slow, hours), 4-factor PCC, or fresh frozen plasma (emergencies).
INR monitoring is essential. Check every 3-4 days on initiation until stable; then weekly-fortnightly for a month; then monthly once stable (or longer in experienced patients). Acute illness, antibiotic courses, diet changes, and new medications all warrant earlier checks.
Bijwerkingen
- Bleeding — major 3-5%/year at therapeutic INR
- Warfarin skin necrosis (rare; 3-10 days after initiation, especially in protein C/S deficiency)
- Purple toe syndrome (rare cholesterol embolisation)
- Hair loss
- Hepatotoxicity (rare)
- INR instability — diet changes, acute illness, interacting drugs all destabilise
Contra-indicaties
- Active bleeding
- Severe uncontrolled hypertension
- Recent major surgery or trauma
- Active peptic ulcer
- Ernstige leverfunctiestoornis
- Pregnancy — warfarin is teratogenic (first trimester) and causes fetal haemorrhage (third trimester); use LMWH
- Planned pregnancy (use LMWH)
- Inability to attend INR monitoring
Geneesmiddelinteracties
- Many drugs alter INR — extensive interaction list. Notable: antibiotics (ciprofloxacin, metronidazole, trimethoprim-sulfamethoxazole, erythromycin, clarithromycin raise INR; rifampicin lowers it), amiodarone (roughly doubles INR), fluconazole, miconazole (raise INR substantially), phenytoin, carbamazepine, rifampicin (lower INR).
- Dietary vitamin K — large changes in vitamin K intake (leafy greens) destabilise INR. Keep intake consistent rather than avoiding vitamin K entirely.
- Alcohol — acute heavy intake raises INR; chronic heavy intake can lower it. Moderate, consistent intake is OK.
- NSAIDs, SSRIs, antiplatelets — additive bleeding without INR change.
- Warfarin sensitivity is genotype-dependent — CYP2C9 and VKORC1 variants affect required dose 2-3 fold.
Opslag
Store Waf-5 below 25°C. Keep out of reach of children.
Veelgestelde vragen
Do I need blood tests on Waf-5?
Yes — INR monitoring is essential (every 3-4 days initially, stabilising to every 1-4 weeks). This is warfarin’s main practical burden.
What should I do if I cut myself while on Waf-5?
Apply firm direct pressure for 15-20 minutes without checking. Most minor cuts stop normally; bleeding that continues >20 minutes or bleeds through multiple dressings warrants urgent medical review. Report any black or bloody stools, bright red rectal bleeding, haematuria, unexplained bruising, nosebleeds >15 minutes, or menstrual bleeding much heavier than usual.
Can I take Waf-5 in pregnancy?
No — warfarin is teratogenic in first trimester and causes fetal haemorrhage in third. Switch to LMWH before conception.
What if I need surgery?
Inform the surgical team well in advance. Warfarin is typically stopped 5 days before major surgery; may require bridging with LMWH in high thrombosis risk.
Where can I buy Waf-5 online?
You can buy Waf-5 (warfarin 5 mg, 30-180 tablets) from MedsBase with discreet packaging and worldwide shipping.
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| Sterkte | 5 mg |
|---|---|
| Hoeveelheid | 30 Tabletten, 60 Tabletten, 90 Tabletten, 180 Tabletten |
Waf-5
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