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Cardiovascular

Coumadin

Warfarin · 5 mg · tablet · qty 30

Anticoagulant.

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Common uses & information

Coumadin is a brand of Warfarin, a cardiovascular medication supplied as tablet in a 5 mg strength. It is commonly used for anticoagulant.

An FDA-approved generic (Warfarin) is available and typically costs less than the brand — compare both cash prices in the table above before you fill.

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Price summary

FormClassBrand avgGeneric avgSavings
tablet 5 mgRx$128.00 — generic is cheaper, see recommendation$5.40Generic recommended96%

Clinical information

Typical dosing

Mechanism: inhibits vitamin K epoxide reductase, which blocks activation of clotting factors II, VII, IX, and X, and proteins C and S. Dosing is NOT one-size-fits-all — it is individualized entirely by INR response: • Typical starting dose: 2–5 mg once daily (many patients end up on 2–10 mg/day). • Elderly, malnourished, or liver-impaired patients: start LOWER (often 2.5 mg or less) — they're more sensitive to warfarin's effect. • Target INR: 2.0–3.0 for most indications (afib, DVT/PE); 2.5–3.5 for a mechanical mitral valve or certain high-risk mechanical valves — your prescriber sets your specific target. • Dose is adjusted in small increments (5–20%) based on INR trend, never by guesswork.

Monitoring

INR (International Normalized Ratio) blood test: checked every 2–3 days when starting or adjusting dose, then weekly, then extended to every 4 weeks (every 4–6 weeks once stable). More frequent checks are needed after any change in diet, illness, new medication, or missed doses.

Side effects

Bleeding is the primary risk (see boxed warning) — from minor bruising and gum bleeding to serious GI or intracranial hemorrhage. Rare: skin necrosis (usually in the first days of therapy, more common with protein C/S deficiency), "purple toe syndrome."

Interactions to know

Warfarin has dozens of clinically significant interactions — always use a drug-interaction checker or ask your pharmacist before starting or stopping ANY medication, including OTC and herbal products. Notable examples that increase bleeding risk or INR: amiodarone, trimethoprim-sulfamethoxazole (TMP-SMX/Bactrim), fluconazole and other azole antifungals, macrolide antibiotics (azithromycin, clarithromycin, erythromycin), NSAIDs (ibuprofen, naproxen), aspirin, and many others. St. John's wort and some other supplements can lower warfarin's effect and increase clotting risk.

Pregnancy & breastfeeding

Warfarin is teratogenic and can cause fetal warfarin syndrome (nasal hypoplasia, skeletal and CNS abnormalities) with exposure in the first trimester, and fetal bleeding risk later in pregnancy. It is contraindicated in pregnancy EXCEPT in specific situations your cardiologist/OB may decide together (e.g. certain mechanical heart valves where alternatives carry unacceptable clotting risk). Anyone who could become pregnant should discuss contraception and alternative anticoagulants with their prescriber.

Additional notes

Reversal (only under medical supervision): vitamin K (phytonadione) for elevated INR or bleeding; 4-factor prothrombin complex concentrate (PCC) is the preferred rapid-reversal agent for serious bleeding or urgent surgery (faster and more complete than plasma); fresh frozen plasma (FFP) is an alternative when PCC isn't available. Dietary: keep vitamin-K intake (leafy greens, etc.) CONSISTENT week to week rather than avoiding it — sudden increases or decreases both throw off INR control. Special populations: elderly patients need lower starting doses and closer monitoring due to increased sensitivity and interacting medications.

Clinical content reviewed by the BetterBuyRx clinical team, on 2026-07-07. Read the full wiki entry and sources →

Manufacturer & patient assistance programs

For patient assistance, check NeedyMeds and RxAssist.

FAQ

Is generic Warfarin the same as Coumadin?

Yes. The FDA requires generics to contain the same active ingredient at the same strength as the brand. Inactive ingredients (binders, dyes) may differ.

How much can I save by choosing the generic?

On average $122.60 per fill (96% off the brand price). Savings vary by pharmacy — see live prices above.

Do I need insurance to get this price?

No. The prices shown on BetterBuyRx are cash prices. Often these beat insurance copays for generics.

How often is this price updated?

At minimum every 72 hours. Many sources refresh every few hours.

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Information for general comparison only. Not medical advice. Confirm with your pharmacist.