Nicoumalone

Nicoumalone is an anticoagulant, with actions, interactions and adverse effects similar to warfarin.

Nicoumalone is primarily indicated in conditions like Deep vein thrombosis, Duodenal erosions, Myocardial infarction, Prevention of thrombosis, Prophylaxis of embolization, Prosthetic heart valves, Pulmonary embolism, Rheumatic heart disease.

Nicoumalone is contraindicated in conditions like Hemorrhage, Cerebrovascular disease.

The severe or irreversible adverse effects of Nicoumalone, which give rise to further complications include Skin necrosis. Nicoumalone produces potentially life-threatening effects which include Hemorrhage, GI bleeding, Hematuria, Bruising, which are responsible for the discontinuation of Nicoumalone therapy. The signs and symptoms that are produced after the acute overdosage of Nicoumalone include Bleeding.

Nicoumalone should be used with caution in patients with ulcers, unusual menstrual periods, diabetes, liver or kidney disease, high blood pressure, arthritis, thyroid problems, all recent infections, if have had recent surgery or of drug and food allergies. If patient have an illness that causes vomiting, diarrhea or fever for more than a few days, contact the doctor as these problems can change the effect of drug. Limit consumption of alcoholic beverages. Avoid sudden changes in dietary habits, Avoid ingesting unusual increases or decreases of foods high in Vitamin K (e.g. liver, cauliflower, cabbage, spinach and other green leafy vegetables, green tea, certain vegetables, cheeses and certain vitamin supplements). It is best to avoid strictly vegetarian diets that consist of foods high in vitamin K. Be extra careful to avoid injuries, because this medication can cause heavy bleeding. Be careful while brushing teeth or use an electric razor. It should not be used during pregnancy. It should be used with caution during lactation.

Drug should not be given to Pediatrics, Pregnant Mothers, Cardiac / Hypertensive Patients, patients suffering from Kidney dysfunction, patients suffering from Liver Malfunction, 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.

0.014 to 0.114 mg/kg (0.064 (0.064)) As recommended. PO — Maintenance, As required 0.114 to 0.171 mg/kg (0.14 (0.1425)) 24 hourly PO — Initial, Reduce dose on second day

( ) — Not recommended in this age group

( ) — Not recommended in this age group

Nicoumalone is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAspirinCarbamazepineCimetidine (HCl)ClopidogrelCo-TrimoxazoleMetronidazolePhenobarbitoneSulphinpyrazoneSulphinpyrazoneVitamin K 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.

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