| Acenocoumarol Pharmacology |
| Acenocoumarol |
| About Acenocoumarol |
| Anticoagulant (blood thinner), Thromboembolic complications. |
| Mechanism of Action of Acenocoumarol |
| Mechanism of action: It exerts it`s pharmacological action by inhibiting regeneration of active hydroquinone from vitamin K and behaves as a competitive antagonist of vitamin K. Thus the drug interacts with synthesis of vitamin K derived clotting factors (factors; II, VII, IX, and X.) in a dose dependent manner and reduce their plasma levels. Vitamin K-hydroquinone is required for final step of gama-carboxylation of descarboxy forms of these factors. This carboxylation is essential for the ability of the clotting factors to bind Ca2+ and to get bound to phospholipid surfaces and ultimately involve in coagulation cascade. |
| Pharmacokinets of Acenocoumarol |
| Absorption: Well absorbed orally, Distribution: Widely distributed in a protein bound form and crosses the placental barrier. Metabolism: Metabolized in the body in to an active metabolite. |
| Onset of Action for Acenocoumarol |
| Rapid |
| Duration of Action for Acenocoumarol |
| 2 to 3 days |
| Half Life of Acenocoumarol |
| 8 to 24hours |
| Side Effects of Acenocoumarol |
| 1.Haemorrhage 2.Ulceration 3.Gastrointestinal disturbances 4.Nausea 5.Vomiting 6.Dermatitis 7.Hypersensitivity reactions 8.Urticaria 9.Rash 10.Reversible alopecia 11.Liver diseases 12.Pancreatitis |
| Contra-indications of Acenocoumarol |
| 1.Hypersensitivity to the drug 2.Bleeding disorders 3.Ulceration of gastrointestinal tract 4.In sub acute bacterial endocarditis 5.Severe hypertension 6.Increased capillary permeability 7.Within one day of surgery or labour 8.Renal impairment 9.Hepatic impairment. |
| Special Precautions while taking Acenocoumarol |
| Use with caution in following conditions: 1.Hepatic diseases 2.Renal diseases 3.Gastrointestinal tract disorders 4.Hypertension 5.Immediately after surgery |
| Pregnancy Related Information |
| Contraindicated. |
| Old Age Related Information |
| Use with caution. |
| Breast Feeding Related Information |
| Use with Caution. |
| Children Related Information |
| Contraindicated |
| Indications for Acenocoumarol |
| 1.Thromboembolism 2.Pulmonary embolism 3.Transient ischemic attack 4.Atrial fibrillation 5.Rheumatic heart disease |
| Interactions for Acenocoumarol |
| Drugs which enhance efficacy of Acenocoumarol: NSAIDs, Amiodarone, Antibacterial agents (Cotrimoxazole, Cephalosporins, Erythromycin, Quinolone antibiotics, Chloramphenicol, Doxycycline, INH, Neomycin) Cimetidine, Allopurinol, Diuretics and Oral anticoagulants. Drugs which decrease efficacy: Bismuth bicarbonate, Rifampicin, Barbiturates, Griseofulvin, Magnesium. Oral hypoglycemic agents: Efficacy of these enhanced. Vit. K: Reverses effects |
| Typical Dosage for Acenocoumarol |
| Starts with 8 to12mg on 1st day. 4 to 8mg on 2nd day. Maintenance dosage: 1 to 8mg daily. |
| Schedule of Acenocoumarol |
| H |
| Storage Requirements for Acenocoumarol |
| Store at room temperature in a light resistant container. |
| Effects of Missed Dosage of Acenocoumarol |
| Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose. |
| Effects of Overdose of Acenocoumarol |
| In minor haemorrhage stoppage of drug is adequate as a treatment measure. In more advanced haemorrhage administration of Phytonadione (vitamin K1) is required. In severe haemorrhage administer fresh frozen plasma or blood. |