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Acenocoumarol

An oral coagulant drug used in rat poisoning,a symmetrical isocoumarin can be considered as the "parent" of the widely used anticoagulant drug, warfarin. More

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Description

An oral coagulant drug used in rat poisoning,a symmetrical isocoumarin can be considered as the "parent" of the widely used anticoagulant drug, warfarin.

Generic Name

Acenocoumarol

Chemical names

Acenocoumarin, Nicoumalone, Nitrovarfarian, Sintrom, Nitrowarfarin

Brand names

Sintrom and Sinthrome, Acitrom (0.5mg, 1mg, 2mg3 mg, 4 mg), Nistrom, Nistrom (2 mg, 4mg) Acenomac (2mg, 3mg, 4mg).

IUPAC name

4-hydroxy-3-[1-(4-nitrophenyl)-3-oxobutyl]-2H-chromen-2-one

Pharmacokinetics

  • Absorption: Rapidly absorbed orally with greater than 60% bioavailability
  • Distribution: 98.7% protein bound, mainly to albumin
  • Metabolism: Extensively metabolized in the liver via oxidation forming two hydroxy metabolites and keto reduction producing two alcohol metabolites.
  • Excretion: via the kidney as metabolites

Actions

Acenocoumarol inhibits the reduction of vitamin K by vitamin K reductase. This prevents carboxylation of certain glutamic acid residues near the N-terminals of clotting factors II, VII, IX and X, the vitamin K-dependent clotting factors. Glutamic acid carboxylation is important for the interaction between calcium and these clotting factors. Without this interaction, clotting cannot occur. Both the extrinsic (via factors VII, X and II) and intrinsic (via factors IX, X and II) are affected by acenocoumarol.

Dosage/Dosage form

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 by oral route of administration.

Therapeutic uses

Antithrombotic/Anticoagulant, Rodenticide

Adverse effects/Side effects

Tachycardia, hypotension, gastrointestinal bleeding, and peripheral circulatory disorders due to loss of blood, nausea, vomiting, diarrhea and abdominal pains.

Interaction

  • Abciximab, Acetyl salicylic acid, Allopurinol, Aceclofenac, Acetaminophen may increase the anticoagulant activities of acenocoumarol.
  • Potentiated by NSAIDs, amiodarone, antibacterial agents, hypoglycaemic agents. 
  • Renal excretion of metabolites is decreased when administered with grapefruit juice.

Contraindications

Lactation, Active haemorrage or risk of serious haemorrage; severe hypertension; pregnancy.

Storage

Store in a room temperature.

Information

Molecular weight

353.3255

Molecular formula

C19H15NO6

CAS number

152-72-7

Precautions

Avoid alcohol. Bleeding disorder, peptic ulcers, severe wounds, cerebrovascular disorders, bacterial endocarditis, renal or hepatic impairment, lactation.