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Acenocoumarol Uses |
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Thromboembolic disorders
Adult: Initially: 2-4 mg daily for 2 days. Alternatively, 6 mg on the 1st day as loading dose, followed by 4 mg on the 2nd day. Subsequent dose adjusted according to response.
Maintenance: 1-8 mg daily. Administer at the same time each day.
Elderly: Reduce dose if necessary.
Renal impairment: Severe: Contraindicated.
Hepatic impairment: Severe: Contraindicated.
Acenocoumarol is used to prevent and treat blood clots in blood vessels; eg. Atrial fibrillation(disorder in rhythm and speed of heart where there is an increased the chances of clots formation in the body, causing strokes), after heart attack,artificial heart valves, deep venous thrombosis (blood clot in the leg) and pulmonary embolism (blood clot in the lung).
Acenocoumarol is a coumarin derivative used as an anticoagulant. Coumarin derivatives inhibit the reduction of vitamin K by vitamin K reductase. This prevents carboxylation of vitamin K-dependent clotting factors, II, VII, XI and X, and interferes with coagulation. Hematocrit, hemoglobin, international normalized ratio and liver panel should be monitored. Patients on Acenocoumarol are prohibited from giving blood.
The dosing regimen of Sin is individual. The initial dose is 5-20 mg. If necessary the dose is increased every 4 weeks. Simvastatin is taken 1 time / day in the evening. The maximum dose is 40 mg / day.
For patients receiving immunosuppressive drugs, the recommended starting dose is 5 mg; the maximum dose is 5 mg / day.
In severe renal insufficiency (creatinine clearance less than 30 ml / min), the initial dose is 5-10 mg / day.
The following medicines may enhance the effect of Acenocoumarol (increased INR; Acenocoumarol dose may need reducing):
• allopurinol
• amiodarone
• antibiotic medicines (eg ampicillin, ciprofloxacin, co-trimoxazole, erythromycin, metronidazole)
• antifungal medicines (eg fluconazole, ketoconazole, miconazole)
• anabolic steroids (oxymetholone, stanozolol)
• aspirin (may also irritate the stomach lining, which can result in bleeding from the stomach or intestine in people taking Acenocoumarol)
• certain chemotherapy regimens
• cimetidine
• danazol
• dextropropoxyphene (found in co-proxamol/Distalgesic)
• diflunisal
• dipyridamole
• disulfiram
• fibrate medicines (eg bezafibrate, ciprofibrate, clofibrate)
• flutamide
• glucagon (large doses)
• non-steroidal anti-inflammatory drugs (NSAIDs, eg ibuprofen and particularly azapropazone, diclofenac, flurbiprofen, indometacin, phenylbutazone, piroxicam. NSAIDs may also irritate the stomach and intestinal lining, which can result in bleeding from the gut in people taking Acenocoumarol. The interaction does not generally apply to NSAIDs applied to the skin.)
• omeprazole
• paracetamol (long-term regular use, occassional painkilling doses should not affect Acenocoumarol significantly)
• propafenone
• statins such as rosuvastatin, simvastatin
• sulfinpyrazone
• tamoxifen
• thyroxine (levothyroxine)
The following medicines may reduce the effect of Acenocoumarol (decreased INR; Acenocoumarol dose may need increasing):
• aminoglutethimide
• azathioprine
• barbiturates, including phenobarbitone and primidone
• carbamazepine
• certain chemotherapy regimens
• colestyramine
• griseofulvin
• oestrogens
• progestogens
• raloxifene
• rifampicin
• sucralfate
• the herbal remeday St John’s wort (Hypericum perforatum)
• vitamin K
Digestive system: constipation, diarrhea, loss of appetite, flatulence, nausea, abdominal pain, pancreatitis, increased ALT, AST, GGT, ALP.
CNS and peripheral nervous system: headache, dizziness, muscle cramps, paresthesia, peripheral neuropathy.
Cardiovascular system: possible transient hypotension.
Musculoskeletal system: myalgia, myopathy, rhabdomyolysis, increased CPK.
Allergic reactions: seldom - angioedema, lupus like syndrome, vasculitis, thrombocytopenia, eosinophilia, ESR increase, arthritis, rash, fever, shortness of breath.
Dermatological reactions: photosensitivity, skin rash, itching, redness of skin, alopecia.
Other: anemia.
• Allergy to other coumarin anticoagulants, eg warfarin
• Active bleeding
• People who are more prone to bleeding than normal, eg due to the blood clotting disorder haemophilia
• Severe kidney disease
• Severe liver disease
• Bacterial infection of the heart valves and the lining surrounding the heart (bacterial endocarditis)
• Uncontrolled high blood pressure (hypertension)
• Peptic ulcer
• Pregnancy
• People who have recently had or are due to have surgery on the brain, spinal cord or eyes.
• This medicine is not recommended for children.
Acenocoumarol
Unit description / dosage (Manufacturer) | Price, USD |
Tablet; Oral; Acenocoumarol 1 mg | |
Sintrom 4 mg Tablet | $ 1.60 |
Sintrom 1 mg Tablet | $ 0.51 |
Tablets; Oral; Acenocoumarol 1 mg | |
List of Acenocoumarol substitutes (brand and generic names): | |
Acencumarol Polfa Warszawa (Poland) | |
Acenocoumarol 1A (Netherlands) | |
Acenocoumarol Actavis (Netherlands) | |
Acenocoumarol Aurobindo (Netherlands) | |
Acenocoumarol CF (Netherlands) | |
Acenocoumarol Gen Med (Argentina) | |
Acenocoumarol Merck (Netherlands) | |
Acenocoumarol Mylan (Netherlands) | |
Acenocoumarol PCH (Netherlands) | |
Acenocoumarol ratiopharm (Netherlands) | |
Acenocoumarol Rospaw (Argentina) | |
Acenocoumarol Sandoz (Netherlands) | |
Acenocoumarol Teva (Netherlands) | |
Acenocoumarol Unipharm (Bulgaria) | |
Acenocumarol (Bosnia & Herzegowina, Lithuania, Poland, Romania) | |
Tablet; Oral; Acenocoumarol 4 mg (Laropharm) | |
Tablets; Oral; Acenocoumarol 4 mg (Laropharm) | |
Acenocumarol 4mg Elifarma (Paraguay) | |
Acenocumarol Laropharm (Romania) | |
Acenocumarol WZF (Poland) | |
Acenocumarol WZF Polfa (Lithuania) | |
Acenokumarol (Bosnia & Herzegowina) | |
Acenokumarol Replek (Macedonia) | |
ACENOKUMAROL REPLEK FARM (Bosnia & Herzegowina) | |
Acenokumarol Union (Serbia) | |
ACENOMAC (India) | |
ACENOMAC 1 MG TABLET 1 strip / 10 tablets each (Macleods (Procare AHT)) | $ 0.71 |
ACENOMAC 2 MG TABLET 1 strip / 10 tablets each (Macleods (Procare AHT)) | $ 1.19 |
ACENOMAC 3 MG TABLET 1 strip / 10 tablets each (Macleods (Procare AHT)) | $ 1.35 |
ACENOMAC 4 MG TABLET 1 strip / 10 tablets each (Macleods (Procare AHT)) | $ 1.44 |
ACENOMAC tab 1 mg x 10's (Macleods (Procare AHT)) | $ 0.71 |
ACENOMAC tab 2 mg x 1's (Macleods (Procare AHT)) | $ 1.19 |
ACENOMAC tab 3 mg x 10's (Macleods (Procare AHT)) | $ 1.35 |
ACENOMAC tab 4 mg x 10's (Macleods (Procare AHT)) | $ 1.44 |
Acenomac 1mg Tablet (Macleods (Procare AHT)) | $ 0.07 |
Acenomac 2mg Tablet (Macleods (Procare AHT)) | $ 0.12 |
Acenomac 3mg Tablet (Macleods (Procare AHT)) | $ 0.13 |
Acenomac 4mg Tablet (Macleods (Procare AHT)) | $ 0.14 |
Acenotromb (Argentina) | |
Acenox (Chile) | |
Tablet; Oral; Acenocoumarol 4 mg (Pasteur) | |
Tablets; Oral; Acenocoumarol 4 mg (Pasteur) | |
ACETHROMB | |
ACETHROMB 1MG TABLET 1 strip / 10 tablets each (Suvik Hitek Pvt Ltd) | $ 0.50 |
ACETHROMB 2MG TABLET 1 strip / 10 tablets each (Suvik Hitek Pvt Ltd) | $ 0.68 |
ACETHROMB 3MG TABLET 1 strip / 10 tablets each (Suvik Hitek Pvt Ltd) | $ 0.86 |
See 173 substitutes for Acenocoumarol |
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Information checked by Dr. Sachin Kumar, MD Pharmacology
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