Basic Marevan Information

• International Nonproprietary Name (INN): Warfarin
• Brand Names Available in Australia: Marevan, Coumadin
• ATC Code: B01AA03
• Forms & Dosages:
  • Tablets: 1 mg, 3 mg, 5 mg
• Manufacturers in Australia: GlaxoSmithKline, Aspen Pharmacare
• Registration Status in Australia: Registered
• OTC / Rx Classification: Prescription only

Latest Research Highlights

Recent studies in Australia have reinforced the pivotal role of Marevan (Warfarin) in anticoagulation therapy management, especially for those with atrial fibrillation. A notable review published in 2022 by the Australian Society of Clinical Hematology has emphasized the significance of Vitamin K antagonists, particularly for certain patient demographics. Even as newer direct oral anticoagulants (DOACs) like Rivaroxaban and Apixaban are increasingly preferred due to their convenience and the absence of the need for regular INR monitoring, Marevan continues to be a reliable choice for many Australian patients. This is largely attributed to its PBS-listed status, which ensures that it is accessible and affordable across urban and rural areas. On a global scale, a meta-analysis from 2023 indicated that with appropriate management and monitoring, Warfarin maintains a strong safety profile. Key findings reveal that proper INR management is essential in mitigating the risk of bleeding complications. Research data further illustrate that the occurrence of severe adverse effects diminishes when routine INR assessments are conducted, underscoring the need for consistent patient education and strict adherence to monitoring protocols. Marevan’s cost-effectiveness remains a compelling reason to consider it, especially in populations sensitive to medication costs.

Implications for Patient Care

The ongoing relevance of Marevan calls for a commitment to education regarding anticoagulation therapy. - **Regular Monitoring**: A consistent INR monitoring schedule must be established to keep patients within the therapeutic range and avoid complications. - **Patient Engagement**: Encourage patients to actively participate in their care by providing clear guidelines on maintaining dietary habits, especially concerning Vitamin K intake, which can influence medication efficacy. - **Medical Support**: The importance of regular consultations with healthcare providers cannot be overstated, as it ensures that adjustments to therapy can be made swiftly, enhancing safety and effectiveness. Continued research and support are essential in maximising the benefits of Marevan and improving patient outcomes across Australia.

Composition & Brand Landscape

Marevan is formulated with Warfarin as its active ingredient, functioning primarily as a Vitamin K antagonist. This means it inhibits the synthesis of vital clotting factors that rely on Vitamin K, a crucial process in preventing blood clots.

In Australia, you’ll find Marevan tablets available in strengths of 1 mg, 3 mg, and 5 mg. These are predominantly packaged in familiar blister packs, manufactured by well-respected companies like GlaxoSmithKline and Aspen Pharmacare.

Understanding the brand landscape is key, especially when comparing Marevan to its notable competitor, Coumadin, which has a stronger international presence. The Pharmaceutical Benefits Scheme (PBS) further tilts the scale in Marevan's favour, allowing for reduced co-payments. As a result, many patients opt for Marevan, particularly as options for generics become more prevalent.

The reputation of Marevan as a reliable anticoagulant in Australia is bolstered by its extensive utilisation, robust quality assurance practices from its manufacturers, and a widespread network of pharmacists who offer ongoing patient counselling and support.

Contraindications & Special Precautions

Marevan presents several absolute contraindications that are vital for healthcare providers and patients to understand. Notably, it is contraindicated in pregnancy due to the serious risks of teratogenic effects and potential fetal bleeding. Other crucial contraindications include:

• Active major bleeding
• Recent high-risk surgical procedures
• Severe uncontrolled hypertension
• Significant liver dysfunction

In Australia, certain demographics may require special consideration. For example, elderly patients are frequently at an elevated risk for complications. Indigenous Australians may also experience unique health disparities that necessitate tailored anticoagulation strategies. These groups need careful monitoring to mitigate adverse effects.

Relative contraindications include:

• A history of falls
• Recent central nervous system surgeries
• Alcohol use disorders

Regular INR monitoring is essential for those in high-risk categories to maintain a therapeutic balance whilst safeguarding patient safety.

Dosage Guidelines

When it comes to dosing, Marevan requires a personalised touch. Factors such as age, weight, and overall health can impact the recommended doses.

Initially, a daily dose of 2 mg to 5 mg is common. The goal is to establish an INR target, typically between 2.0 and 3.0. Patients with mechanical heart valves may need higher targets.

For children, the dosing is much more nuanced and usually adjusted based on body weight and age. Close monitoring is essential, often necessitating specialist oversight. Elderly individuals may need to start at a lower dose, frequently beginning with 2 mg per day due to increased sensitivity to Warfarin.

Although no direct adjustments are needed for those with renal impairment, vigilance in monitoring INR levels is critical, given the heightened risks of bleeding. Treatment regimens generally span:

• 3-6 months for venous thromboembolism (VTE)
• Indefinite for atrial fibrillation or recurrent thromboembolic incidents

Patient education about missed doses is vital. If a dose is forgotten, it should be taken once remembered unless it's close to the next scheduled dose to avoid doubling up.

Interactions Overview

Marevan, a brand of warfarin, interacts notably with certain foods and medications, raising questions about daily habits for those managing their anticoagulation therapy. Many patients wonder how their choices can impact their treatment. A critical area of concern is dietary intake of Vitamin K-rich foods. Leafy greens such as kale, spinach, and brussels sprouts can significantly affect the effectiveness of Marevan. Inconsistent Vitamin K intake may lead to fluctuations in INR levels—making ongoing dietary education essential.

Alcohol consumption is another factor that can alter warfarin metabolism. Moderate consumption is recommended, and patients should consult their healthcare provider regarding their specific circumstances. Common over-the-counter medications present additional risks. For example, non-steroidal anti-inflammatory drugs (NSAIDs) can increase the risk of bleeding when taken alongside Marevan.

From a pharmaceutical angle, many medications can influence warfarin metabolism. Certain drugs, like antibiotics, antifungals, and some herbal supplements may either heighten bleeding risks or reduce the anticoagulant effects. Identifying such interactions during consultations is crucial for preventing complications and ensuring effective management.

Regular INR monitoring serves as a valuable tool in detecting interactions early. The Therapeutic Goods Administration's e-health systems enable healthcare providers to track potential drug interactions efficiently, allowing timely responses to ensure patient safety while on Marevan.

Vitamin K Effects

When considering Marevan interactions, the role of Vitamin K cannot be overlooked. It acts in direct opposition to the anticoagulant effects of warfarin, and therefore, understanding this relationship is vital for effective treatment management.

Patients receiving Marevan should maintain a consistent intake of Vitamin K because:

• Fluctuations can lead to unpredictable INR levels.
• Excessive Vitamin K can reduce the medication's effectiveness.
• A stable diet helps in maintaining the desired INR target.

Educating patients about the importance of maintaining a balanced diet, rather than severely limiting Vitamin K, is essential. This ensures effective anticoagulation without unnecessary complications.

Monitoring and Safety

In the management of patients taking Marevan, frequent INR monitoring is necessary. Regular checks allow healthcare providers to adjust doses as needed, preventing the likelihood of severe bleeding or clotting complications.

Additionally, patients should be aware of the signs of potential drug interactions and adverse effects. Knowledge of what to watch for can lead to quicker intervention and better outcomes. Encouraging open discussions about dietary choices and medication use can empower patients in their treatment journey.

Consultation with healthcare professionals remains the best approach to navigating these challenges. Regular follow-ups ensure that patients are managing their medications and dietary needs safely.

Delivery Options for Marevan

Town	Region	Delivery Time
Sydney	NSW	5–7 days
Melbourne	VIC	5–7 days
Brisbane	QLD	5–7 days
Perth	WA	5–7 days
Adelaide	SA	5–7 days
Hobart	TAS	5–9 days
Canberra	ACT	5–7 days
Gold Coast	QLD	5–9 days
Newcastle	NSW	5–9 days
Cairns	QLD	5–9 days
Geelong	VIC	5–9 days
Central Coast	NSW	5–9 days
Wollongong	NSW	5–9 days
Sunshine Coast	QLD	5–9 days