In this class of drugs are distinguished:
- Warfarin
- Dicumarolo
- Phenprocoumon
- Fenindione
- Phytonadione (Vit. K1)
Warfarin
Coumarin antithrombotic drug, also used as a rodenticide, naturally occurring as bishydroxycoumarin and synthesized as dicumarol.
Clinically used warfarin consists of a racemic mixture characterized by equal aliquots of two enantiomorphs. Left-handed S-warfarin is four times more potent than right-handed R-warfarin.
Coumarin anticoagulants block the gamma-carboxylation of some glutamic residues of prothrombin and factors VII, IX and X as well as the endogenous anticoagulant protein C.
Phenprocoumon
Coumarin anticoagulant drug analogous and similar to walfarin and dicumarol.
Vitamin K antagonists other than walfarin are rarely used due to their less favorable pharmacological properties or increased toxicity. Phenprocoumon has a long half-life (6 days). In Italy it is not present in any specialty.
Clinically proven interactions of oral anticoagulants
Oral anticoagulants exhibit inducible metabolic properties, with the possibility of metabolism inhibition.
They exhibit the possibility of elevated binding to plasma proteins.
The anticoagulant effect is altered by drugs that modify the synthesis or catabolism of coagulation factors.
Drugs that can increase the anticoagulant effect:
- Amiodarone
- Quinidine
- Cimetidine
- Ciprofloxacin
- Clofibrate
- Chloramphenicol
- Danazol
- Disulfiram
- D-thyroxine
- Erythromycin
- NSAIDs
- Phenylbutazone
- Fluconazole
- Gemfibrozil
- Lovastatin
- Metronizadol
- Miconazole
- Thyroid hormones
- Propafenone
- Salicylates
- Anabolic steroids
- Sulfonamides
- Sulfinpyrazone
- Trimethoprim-sulfamethoxazole
Drugs which may decrease the anticoagulant effect
- Aminoglutethimide
- barbiturates
- Carbamazepine
- Cholestyramine
- Phenytoin
- Glutethimide
- Nafcillin
- Primidone
- Rifampicin
Effects of coumarin anticoagulant drugs on other drugs
- Phenytoin
- Oral hypoglycemic agents
The information on coumarin anticoagulants published on this page may be out of date or incomplete. For a correct use of this information, see the Disclaimer and useful information page.
