Generic Medicine Info
Haemorrhagic diathesis and blood dyscrasia (e.g. haemophilia, thrombocytopenic purpura, leukaemia), peptic ulcer or haemorrhage of the GI tract, urogenital tract or resp system; cerebrovascular haemorrhage, acute pericarditis, pericardial effusion, infective endocarditis, severe HTN. Recent or potential surgery of the eyes/CNS. Recent surgery resulting in increased fibrinolytic activity (e.g. surgery of the lung, prostate, uterus). Uncooperative patient (e.g. unsupervised senile, alcoholic, psychotic, w/ dementia). Severe hepatic and renal impairment. Pregnancy.
Special Precautions
Patient w/ severe heart failure, known or suspected protein C or S and vit K deficiency. Mild to moderate hepatic and renal impairment. Elderly. Lactation. Monitoring Parameters Determine prothrombin time (PT)/INR (daily or on alternate days in early days of treatment, then at longer intervals depending on response) Monitor CBC, hepatic and renal function.
Adverse Reactions
Rarely, urticaria, rash, dermatitis, purpura, skin necrosis; fever, decreased appetite, nausea, vomiting, diarrhoea; alopecia; hepatic dysfunction, jaundice, pancreatitis; purple toe syndrome.
Potentially Fatal: Haemorrhage.
Drug Interactions
Increased effect w/ antiarrhythmics (e.g. amiodarone, quinidine), antibiotics (e.g. broad spectrum antibiotics, tetracyclines, chloramphenicol), antifungal (e.g. metronidazole), SSRIs (e.g. citalopram, fluoxetine, sertraline, paroxetine), antigout (e.g. allopurinol), lipid-regulating drugs (e.g. atorvastatin, fluvastatin, simvastatin), and inhibitors of CYP2C9 isoenzyme. Reduced anticoagulant effect w/ antineoplastics (e.g. azathioprine, 6-mercaptopurine), antivirals (e.g. ritonavir, nelfinavir), thiazide diuretics, oral contraceptives, and inducers of CYP2C9, CYP2C19, and CYP3A4 isoenzymes. May increase the serum hydantoin concentration of phenytoin. May potentiate the hypoglycaemic effect of sulphonylurea derivatives (e.g. glibenclamide, glimepiride).
CIMS Class
Anticoagulants, Antiplatelets & Fibrinolytics (Thrombolytics)
ATC Classification
B01AA07 - acenocoumarol ; Belongs to the class of vitamin K antagonists. Used in the treatment of thrombosis.
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