Dicumarol

Dicumarol is a coumarin-like compound found in sweet clover. It is used as an oral anticoagulant and acts by inhibiting the hepatic synthesis of vitamin K-dependent coagulation factors (prothrombin and factors VII, IX, and X). It is also used in biochemical experiments as an inhibitor of reductases. Dicumarol inhibits vitamin K reductase, resulting in depletion of the reduced form of vitamin K (vitamin KH2). As vitamin K is a cofactor for the carboxylation of glutamate residues on the N-terminal regions of vitamin K-dependent proteins, this limits the gamma-carboxylation and subsequent activation of the vitamin K-dependent coagulant proteins. The synthesis of vitamin K-dependent coagulation factors II, VII, IX, and X and anticoagulant proteins C and S is inhibited. Depression of three of the four vitamin K-dependent coagulation factors (factors II, VII, and X) results in decreased prothrombin levels and a decrease in the amount of thrombin generated and bound to fibrin. This reduces the thrombogenicity of clots. Anticoagulants decrease the clotting ability of the blood and therefore help to prevent harmful clots from forming in the blood vessels. These medicines are sometimes called blood thinners, although they do not actually thin the blood. They also will not dissolve clots that already have formed, but they may prevent the clots from becoming larger and causing more serious problems. They are often used as treatment for certain blood vessel, heart, and lung conditions.

Dicumarol is primarily indicated in conditions like Blood clot.

Dicumarol is contraindicated in conditions like Hypersensitivity to the drug.

The symptomatic adverse reactions produced by Dicumarol are more or less tolerable and if they become severe, they can be treated symptomatically, these include Dizziness, Diarrhea, Confusion, Nausea and vomiting, Chest pain, Shortening of breath, Backache.

Harmful if swallowed. May cause eye and skin irritation. May cause respiratory tract irritation. May cause reproductive and fetal effects.

Drug should not be given to Pregnant Mothers, Cardiac / Hypertensive Patients, patients suffering from Liver Malfunction, Geriatrics, and Neonates. If prescribing authority justifies the benefits of the drug against the possible damages, he/she should reevaluate them and consult the reference material and previous studies.

25 to 200 mg/day (110 (112.5)) As recommended. PO — dose should be adjusted according to blood tests.

No child dosage information is recorded for this medicine yet.

No neonatal dosage information is recorded for this medicine yet.

Dicumarol is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementHydrocortisoneMethyltestosteroneAndrogens and anabolic steroids may potentiate the hypoprothrombinemic response to oral anticoagulants and increase the risk of bleeding. The onset of interaction is generally observed within 2 to 3 days. The mechanism is unknown.MajorDuring concomitant therapy, the INR and/or PT should be monitored closely and anticoagulant dosage adjusted accordingly, particularly following initiation, discontinuation or change of dosage of the androgenic agent in patients who are stabilized on their anticoagulation regimen. Significant anticoagulant dose reductions may be required. Some experts recommend avoiding this combination altogether. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.MitotaneMitotane may decrease the effectiveness of orally administered anticoagulants. The mechanism is induction of hepatic microsomal enzymatic clearance. Data are available for warfarin. ModerateClose monitoring for clinical and laboratory evidence of altered anticoagulant efficacy is recommended. The dosage requirements for orally administered anticoagulants are expected to increase after mitotane is added. The clinician should be also be aware that the risk of bleeding from over-anticoagulation is increased when mitotane is withheld.OxandroloneAndrogens and anabolic steroids may potentiate the hypoprothrombinemic response to oral anticoagulants and increase the risk of bleeding. The onset of interaction is generally observed within 2 to 3 days. The mechanism is unknown. There have been case reports of patients stabilized on oral anticoagulant therapy who developed bleeding complications following the addition of various androgenic agents including danazol, oxymetholone, testosterone, methyltestosterone, and stanozolol.MajorDuring concomitant therapy, the INR and/or PT should be monitored closely and anticoagulant dosage adjusted accordingly, particularly following initiation, discontinuation or change of dosage of the androgenic agent in patients who are stabilized on their anticoagulation regimen. Significant anticoagulant dose reductions may be required. Some experts recommend avoiding this combination altogether. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.OxpentifyllineConcurrent use increases the anticoagulant effect.OxymetholoneAndrogens and anabolic steroids may potentiate the hypoprothrombinemic response to oral anticoagulants and increase the risk of bleeding. The onset of interaction is generally observed within 2 to 3 days. The mechanism is unknown. There have been case reports of patients stabilized on oral anticoagulant therapy who developed bleeding complications following the addition of various androgenic agents including danazol, oxymetholone, testosterone, methyltestosterone, and stanozolol.MajorDuring concomitant therapy, the INR and/or PT should be monitored closely and anticoagulant dosage adjusted accordingly, particularly following initiation, discontinuation or change of dosage of the androgenic agent in patients who are stabilized on their anticoagulation regimen. Significant anticoagulant dose reductions may be required. Some experts recommend avoiding this combination altogether. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.Piroxicam-beta-cyclodextrinPiroxicam potentiates the anticoagulent effect of Dicumarol because of its effect on plateletsTenecteplaseConcurrent use is usually not recommended but may be required in some cases. If both medicines are prescribed together, change of dose may be required. These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

Tabs Store in a well closed container. Protect from Moisture and Heat.