P - Contraindicated in pregnancy
L - Caution when used during lactation
FI - Food *
Acenocoumarol is an anticoagulant that functions as a vitamin K antagonist (like warfarin). It is a derivative of coumarin and is marketed under the brand names Sintrom and Sinthrome. Anticoagulants decrease the clotting ability of the blood and therefore help to prevent harmful clots from forming in the blood vessels. These medicines are sometimes called blood thinners, although they do not actually thin the blood. They also will not dissolve clots that already have formed, but they may prevent the clots from becoming larger and causing more serious problems. They are often used as treatment for certain blood vessel, heart, and lung conditions. In order for an anticoagulant to help without causing serious bleeding, it must be used properly and all of the precautions concerning its use must be followed exactly.
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Alopecia; fever, nausea, vomiting, diorrhea; skin rash; cholestatic liver damage.
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Bleeding disorders; peptic ulcers; severe wounds, cerebrovascular disorders, bacterial endocarditis; renal or hepatic impairment; lactation. Avoid alcohol.
Potentiates hypoglycaemic agents. Bismuth carbonate and Mg reduce absorption. Cimetidine, allopurinol, diuretics and other oral anticoagulants enhance effect. vit K reverses effect. Potentially Fatal: Potentiated by NSAIDs, amiodarone, antibacterial agents eg, co-trimoxazole, cephalosporins, erythromycin, quinolone antibiotics, chloramphenicol, doxycycline, INH and neomycin. Rifampicin, barbiturates and griseofulvin diminish effect.
Food Interaction
Renal excretion of metabolites is decreased when administered with grapefruit juice.
Oral
Thromboembolic disorders Adult: 4-12 mg on the 1st day and 4-8 mg on the 2nd day. Maintenance: 1-8 mg daily given in a single dose at the same time everyday.
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Anticoagulants may cause birth defects. They may also cause other problems affecting the physical or mental growth of the fetus or newborn baby. In addition, use of this medicine during the last 6 months of pregnancy may increase the chance of severe, possibly fatal, bleeding in the fetus. If taken during the last few weeks of pregnancy, anticoagulants may cause severe bleeding in both the fetus and the mother before or during delivery and in the newborn infant. The patient should noy begin to take this medicine during pregnancy, and should not become pregnant while taking it. Anticoagulants may also cause severe bleeding in the mother if taken soon after the baby is born.
Warfarin is not likely to cause problems in nursing babies. Other anticoagulants may pass into the breast milk. A blood test can be done to see if unwanted effects are occurring in the nursing baby. If necessary, another medicine that will overcome any unwanted effects of the anticoagulant can be given to the baby.
Very young babies may be especially sensitive to the effects of anticoagulants. This may increase the chance of bleeding during treatment.
Elderly people are especially sensitive to the effects of anticoagulants. This may increase the chance of bleeding during treatment.
Active haemorrage or risk of serious haemorrage; severe hypertension; pregnancy.
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