Published on 9 March 2023

Please see attached Medication Safety Alert from VicTag highlighting availability of warfarin (Coumadin and Marevan) in new packaging similar to multiple other medication by the manufacturer Mylan/Viatris.

Both brands of warfarin, in all strengths, are now being supplied to multiple health services (and community pharmacies) in identical blue bottles. Many other medicines manufactured by Mylan/Viatris are already supplied in identical blue bottles. As warfarin is a known high risk medicine, the new blue packaging is a risk for selection errors and therefore medication and dose errors by pharmacy and nursing staff. Patients taking warfarin at home are also at increased risk of a selection or dosing error. These errors have the potential to result in a severe or fatal outcome.

Western Health has not transitioned over to the new packaging yet, however patients may be using their own stock with new packaging at home. Healthcare professionals are requested to carefully review when taking medication histories and provide patient and carers education on similar packaging where appropriate.

As an APINCH medication –it is recommended to always take extra care when administering warfarin. Concerns regarding the new packaging have been raised at a state level with the manufacturer and relevant stakeholders through various professional groups.