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Lipitor increases the effect of warfarin coumadin and the concentration in blood of digoxin lanoxin .

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Your risk of having bleeding problems is higher than the possible benefit of treatmentYour healthcare provider will decide if COUMADIN is right for youyou are pregnant unless you have a mechanical heart valveCOUMADIN may cause birth defectsmiscarriageor death of your unborn babyyou are allergic to warfarin or any of the other ingredients in COUMADINSee the end of this leaflet for a complete lis t of ingredients in COUMADIN.

It is not known whether warfarin passes into breast milkWatch for signs of bruising or bleeding in the baby if you take Coumadin while you are breast-feeding a baby.

Some side effects of warfarin may occur that usually do not need medical attentionThese side effects may go away during treatment as your body adjusts to the medicineAlsoyour health care professional may be able to tell you about ways to prevent or reduce some of these side effectsCheck with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Grapefruit juicecranberry juicenoni juiceand pomegranate juice may interact with warfarin and lead to unwanted side effectsAvoid the use of these juice products while taking Coumadin.

Many medications and dietary supplements can affect the way warfarin worksThese include:

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since the full anticoagulant effect of coumadin is not achieved for several days, heparin is preferred for initial rapid anticoagulation.

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