{"id":1604,"date":"2023-06-25T17:27:16","date_gmt":"2023-06-25T17:27:16","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/acenocoumarol\/"},"modified":"2023-06-25T19:58:04","modified_gmt":"2023-06-25T19:58:04","slug":"acenocoumarol","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/acenocoumarol\/","title":{"rendered":"Acenocoumarol"},"content":{"rendered":"

<\/p>\n

Acenocoumarol<\/h1>\n

CLINICAL USE<\/h3>\n

Anticoagulant<\/p>\n

DOSE IN NORMAL RENAL FUNCTION<\/h3>\n

4\u201312 mg on 1st day; 4\u20138 mg on 2nd dayMaintenance dose usually 1\u20138 mg daily according to INR<\/p>\n

PHARMACOKINETICS<\/h3>\n
  • Molecular weight                           :353.3<\/li>\n
  • %Protein binding                           :>98<\/li>\n
  • %Excreted unchanged in urine     : <0.2<\/li>\n
  • Volume of distribution (L\/kg)       :0.16\u20130.18 R(+) enantiomer; 0.22\u20130.34 S(\u2013) enantiomer<\/li>\n
  • half-life \u2013 normal\/ESRD (hrs)      :8\u201311\/Probably unchanged
    \n

    DOSE IN RENAL IMPAIRMENT<\/h3>\n

    GFR (mL\/MIN)<\/h4>\n<\/li>\n
  • 20 to 50     : Dose as in normal renal function<\/li>\n
  • 10 to 20     : Dose as in normal renal function<\/li>\n
  • <10           : Dose as in normal renal function
    \n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES<\/h3>\n<\/li>\n
  • CAPD                :Unknown dialysability. Dose as in normal renal function<\/li>\n
  • HD                     :Unknown dialysability. Dose as in normal renal function<\/li>\n
  • HDF\/high flux   :Unknown dialysability. Dose as in normal renal function<\/li>\n
  • CAV\/VVHD      :Unknown dialysability. Dose as in normal renal function
    \n

    IMPORTANT DRUG INTERACTIONS<\/h3>\n

    Potentially hazardous interactions with other drugs<\/li>\n

  • There Are Many Significant Interactions With Coumarins. Prescribe With Care With Regard To The Following:Anticoagulant effect enhanced by: alcohol, amiodarone, anabolic steroids, aspirin, azithromycin, aztreonam, bicalutamide, cephalosporins, chloramphenicol, cimetidine, ciprofloxacin, clarithromycin, fibrates, clopidogrel, cranberry juice, danazol, dextropropoxyphene, dipyridamole, disulfiram, erythromycin,esomeprazole, ezetimibe, fluconazole, flutamide, fluvastatin, grapefruit juice, itraconazole, ketoconazole, levamisole, levofloxacin, macrolides, methylphenidate, metronidazole, miconazole, nalidixic acid, neomycin, norfloxacin, NSAIDs, ofloxacin, omeprazole, pantoprazole, paracetamol, penicillins, propafenone, ritonavir, rosuvastatin, SSRIs, simvastatin, sitaxentan, sulfinpyrazone, sulphonamides, tamoxifen, testosterone, tetracyclines, levothyroxine, tigecycline, toremifene, tramadol, trimethoprim, valproate, voriconazole<\/li>\n
  • Anticoagulant effect decreased by:acitretin, azathioprine, barbiturates, carbamazepine, griseofulvin, mercatopurine, mitotane, oral contraceptives, phenytoin, primidone, rifampicin, St John\u2019s wort (avoid concomitant use), sucralfate, vitamin K<\/li>\n
  • Anticoagulant effects enhanced\/reduced by: amprenavir, anion exchange resins, corticosteroids, dietary changes, tricyclics<\/li>\n
  • Analgesics: increased risk of bleeding with IV diclofenac and ketorolac \u2013 avoid concomitant use<\/li>\n
  • Antidiabetic agents: enhanced hypoglycaemic effect with sulphonylureasCiclosporin: there have been a few reports of altered anticoagulant effect; decreased ciclosporin levels have been seen rarely<\/li>\n
  • Cytotoxics: increased risk of bleeding with erlotinib and imatinib; enhanced effect with etoposide, fluorouracil, ifosfamide and sorafenib
    \n

    ADMINISTRATION<\/h3>\n

    Reconstition<\/h4>\n

    \u2013<\/p>\n

    Route<\/h4>\n

    Oral<\/p>\n

    Rate of Administration<\/h4>\n

    \u2013<\/p>\n

    Comments<\/h4>\n

    \u2013<\/p>\n

    OTHER INFORMATION<\/h4>\n

    Acenocoumarol prolongs the thromboplastin time within approximately 36\u201372 hoursDecreased protein binding in uraemia<\/li>\n","protected":false},"excerpt":{"rendered":"

    Acenocoumarol CLINICAL USE Anticoagulant DOSE IN NORMAL RENAL FUNCTION 4\u201312<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-1604","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1604","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=1604"}],"version-history":[{"count":1,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1604\/revisions"}],"predecessor-version":[{"id":2921,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1604\/revisions\/2921"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=1604"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=1604"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=1604"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}