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Sintrom

Sintrom

(nicoumalone)

Acenocoumarol belongs to the group of medications called anticoagulants. It is sometimes referred to as a "blood thinner," although it does not actually thin the blood.

Available form

Dosage

Tablet

1MG, 4MG

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Sintrom information

Dosage

Side Effects

Available Form

Contraindications

Precautions

Warnings

The dose of acenocoumarol is individualized by your doctor according to blood clotting time as determined by laboratory tests, called an INR, performed at regular intervals. It is very important to keep your lab appointments, as there is a narrow range between too much and too little of the medication. Too much medication may cause you to bleed more. Too little medication may let a harmful clot form.

The usual dose on the first day ranges from 8 mg to 12 mg and on the second day from 4 mg to 8 mg. The usual maintenance dose ranges from 1 mg to 10 mg once daily. Take acenocoumarol at the same time each day.

Different circumstances in your life (e.g., eating certain foods or using certain medications) can cause Sintrom (Nicoumalone) to work more or less effectively. Ask your doctor or pharmacist for a list of these foods and medications.

It is important to manage your lifestyle appropriately when taking acenocoumarol:

do not make drastic changes in your diet, such as eating large amounts of green, leafy vegetables
do not attempt to change your weight by dieting without first checking with your health care provider
do not participate in any activity or sport that may result in serious injury
avoid drinking alcohol
avoid cutting yourself

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Sintrom (Nicoumalone) exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Sintrom (Nicoumalone) at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Sintrom (Nicoumalone). If you are concerned about side effects, discuss the risks and benefits of Sintrom (Nicoumalone) with your doctor.

The following side effects have been reported by at least 1% of people taking Sintrom (Nicoumalone). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

Diarrhea
Fever
Hives
itchy skin
loss of appetite
loss of hair
nausea
vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

bleeding from cuts that take a long time to stop
bleeding gums
Headaches, dizziness, or weakness
heavier than normal menstrual bleeding
nosebleeds
numbness or tingling of the face, hands, or feet
pain, swelling, or discomfort
paralysis
pink or brown urine
sudden shortness of breath
unexplained bruising
unusual pain or swelling

Stop taking the medication and seek immediate medical attention if any of the following occur:

fainting
signs of a serious allergic reaction, e.g.:
- difficulty breathing
- hives
- swelling of face or throat
signs of bleeding, e.g.:
- bleeding in the eye
- blood in stools
- blood in urine
- blood in vomit or vomit that looks like coffee grounds
- coughing up blood
- dark, tarry stools

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Sintrom (Nicoumalone).

There may be an interaction between acenocoumarol and any of the following:

Acetaminophen
alcohol
Allopurinol
Amiodarone
anticancer medications (e.g., Carboplatin, Cyclophosphamide, Fluorouracil)
Azathioprine
azithromycin
"azole" antifungals (e.g., fluconazole, ketoconazole, miconazole)
barbiturates (e.g., primidone, Phenobarbital)
birth control pills
Carbamazepine
cephalosporins (e.g., cefazolin, cefoperazone, cefotetan, cefoxitin)
chloral hydrate
chloramphenicol
Cholestyramine
Cimetidine
clarithromycin
clofibrate
corticosteroids (e.g. Prednisone, Dexamethasone)
Danazol
delavirdine
dextran
diazoxide
diuretics (e.g. Hydrochlorothiazide)
erythromycin
ethacrynic acid
Fenofibrate
fluoxymesterone
Flutamide
Gemfibrozil
Glucagon
griseofulvin
halothane
Heparin and low-molecular weight heparins (e.g. Enoxaparin, Dalteparin)
herbs that affect blood clotting (e.g., St. John's wort, ginseng, ginkgo biloba, coenzyme Q10)
lidocaine
long-term use of narcotic pain medications (e.g. Codeine, Oxycodone, Morphine, Hydromorphone)
MAO inhibitors (e.g., Phenelzine, Tranylcypromine)
meprobamate

Mercaptopurine
Metronidazole
mexilitine
miconazole
nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., Diclofenac, Ibuprofen, Naproxen, Celecoxib, Mefenamic acid)
Pentoxifylline
phenylbutazone
Phenytoin
potassium iodide
Primaquine
Propafenone
propoxyphene
Propylthiouracil
quinidine
quinine
quinolone antibiotics (e.g., ciprofloxacin, Norfloxacin, Ofloxacin)
rifabutin
rifampin
salicylates (e.g., aminosalicylic acid, sodium salicylate, acetylsalicylic acid [Asa], methyl salicylate)
selective serotonin reuptake inhibitors (SSRIs; e.g., Duloxetine, Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, Citalopram)
"statins" (e.g., Fluvastatin, Lovastatin, Simvastatin)
streptokinase
Sulfinpyrazone
sulfonamides (e.g., sulfamethoxazole)
sulfonylureas (e.g., Glyburide, chlorpropamide, Tolbutamide)
Tamoxifen
testosterone
tetracyclines (e.g., doxycycline, Minocycline, Tetracycline)
thiabendazole
Thyroid hormones (e.g., Levothyroxine, Liothyronine, thyroid)
Ticlopidine
tissue plasminogen activator (t-PA)
urokinase
vitamin E
vitamin K
Warfarin
zafirkulast

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

stop taking one of the medications,
change one of the medications to another,
change how you are taking one or both of the medications, or
leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Sintrom (Nicoumalone). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take Sintrom (Nicoumalone).

Bleeding: The most serious risk associated with acenocoumarol is bleeding in any tissue or organ. The risk of bleeding is related to the level of intensity and the duration of treatment.

It is extremely important to have regular blood tests (as recommended by your doctor) to measure your INR level. Your health care provider will adjust the dose of acenocoumarol depending on your INR level to ensure you are not receiving too little medication (which may result in blood clots forming) or too much medication (which may result in bleeding).

Kidney problems: If you have kidney problems, discuss with your doctor how Sintrom (Nicoumalone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Sintrom (Nicoumalone), and whether any special monitoring is needed.

Liver problems: If you have liver problems, discuss with your doctor how Sintrom (Nicoumalone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Sintrom (Nicoumalone), and whether any special monitoring is needed.

Medical alert: In case of injury or accident, people taking Sintrom (Nicoumalone) should carry a card or wear other identification (e.g., bracelet or necklace) that states they are taking Sintrom (Nicoumalone).

Medical conditions and other medications: Many medical conditions and medications affect the way acenocoumarol works and affect the dosing of Sintrom (Nicoumalone). If you have a medical condition and are taking medications, discuss with your doctor how Sintrom (Nicoumalone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Sintrom (Nicoumalone), and whether any special monitoring is needed.

Always check with your doctor or pharmacist before taking any new prescription or over-the-counter medication, supplement, or herbal product.

Medical procedures: Before undergoing any medical test or procedure (e.g., minor surgery, tooth extractions, angiography), be sure to tell your health care providers that you are taking Sintrom (Nicoumalone).

Stopping the medication: If your doctor has told you that you can stop acenocoumarol, they may recommend that you decrease your dose slowly over time. Do not suddenly stop taking Sintrom (Nicoumalone) without discussing with your doctor first.

Pregnancy: Acenocoumarol should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Sintrom (Nicoumalone), contact your doctor immediately.

Breast-feeding: Acenocoumarol passes into breast milk. If you are a breast-feeding mother and are taking Sintrom (Nicoumalone), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of taking Sintrom (Nicoumalone) have not been established for children.

Seniors: Seniors taking Sintrom (Nicoumalone) may be more sensitive to side effects and may need closer monitoring by their doctors.

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All material © 1996-2024 MediResource Inc. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition.

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