Universal reference book for medicines
Product name: PHENYLIN

Active substance: phenindione

Type: Anticoagulant of indirect action

Manufacturer: HEALTH PHARMACEUTICAL COMPANY (Ukraine)

Description of the active substance:
This information is a reference and it is not enough that the drug has been prescribed by a doctor ..

PHARMACHOLOGIC EFFECT
Anticoagulant of indirect action.
It causes hypoprothrombinemia associated with a violation of the formation of prothrombin in the liver, also causes a decrease in the formation of VII, IX, X coagulation factors, a decrease in plasma tolerance to heparin, a lipid content in the blood, and an increase in vascular permeability. The action occurs in 8-10 hours and reaches a maximum after 24-30 hours after the administration of phenindione.
PHARMACOKINETICS
Clinical data on the pharmacokinetics of fenindione are limited.
Cumulation is less pronounced than that of neodicumarin.
INDICATIONS
Preventive maintenance of a thromboembolism (including at a myocardial infarction, after surgical interventions);
coronary thrombosis, thrombophlebitis and deep vein thrombosis of lower extremities; prevention of thrombosis after surgery for prosthetics of the heart valves (constant reception).
DOSING MODE
Inside the first day, the daily dose is 120-180 mg in 3-4 doses, on the second day - 90-150 mg, then 30-60 mg / day, depending on the content of prothrombin in the blood.
The abolition of fenindion should be carried out gradually.
SIDE EFFECT
On the part of the digestive system: nausea, diarrhea, impaired liver function, toxic hepatitis.

From the hemopoietic system: oppression of bone marrow hematopoiesis.

From the side of the urinary system: renal dysfunction.

From the cardiovascular system: myocarditis.

From the coagulation system: with prolonged use - micro- and macrohematuria, bleeding from the oral cavity and nasopharynx, from the gastrointestinal tract, hemorrhage into the muscles.

From the side of the central nervous system: a headache.

Allergic reactions: skin rash, dermatitis, eosinophilia, fever.

CONTRAINDICATIONS
Hemophilia, hypocoagulation, I trimester of pregnancy, hypersensitivity to phenyldione.

PREGNANCY AND LACTATION
Contraindicated in pregnancy.
Avoid use in the first days after childbirth.
Fenindione should not be used during lactation (breastfeeding).

Fenindion should be discontinued 2 days before the beginning and not applied during menstruation.

APPLICATION FOR FUNCTIONS OF THE LIVER
Caution should be used in cases of kidney failure.

APPLICATION FOR VIOLATIONS OF THE FUNCTION OF KIDNEYS
Caution should be used for liver failure.

APPLICATION IN ELDERLY PATIENTS
Caution should be used in elderly patients.

SPECIAL INSTRUCTIONS
Caution should be used in elderly patients, with hepatic and / or renal insufficiency, pulmonary embolism (including oncology), erosive and ulcerative gastrointestinal lesions, with pericarditis, in the postpartum period.

Treatment should be carried out under close medical supervision with mandatory systematic examination of blood levels of prothrombin and other clotting factors.Systematically conducts general urine tests for the early detection of hematuria.

In some patients, palms are colored orange and urine is pink, which is associated with the metabolism of phenindione.

DRUG INTERACTION
With simultaneous use with ACTH, anticoagulant action is enhanced.

With simultaneous use with dipyridamole, there have been cases of increased bleeding, apparently due to a decrease in adhesiveness and aggregation of platelets under the influence of dipyridamole.

At simultaneous application with klofibratom the anticoagulant action amplifies.
It is believed that fibrates can increase the affinity of oral anticoagulants to the corresponding receptors or, possibly, disrupt the metabolism of anticoagulants.
With simultaneous use with lyotyronine, the anticoagulant effect of phenindione is enhanced.
It is believed that thyroid hormones can increase the affinity of oral anticoagulants to the corresponding receptors.
With simultaneous use with miconazole, the anticoagulant effect of phenindione is enhanced.
Increased risk of bleeding.
With simultaneous use with cimetidine, the anticoagulant effect of phenindione is enhanced due to the slowing of its metabolism in the liver under the influence of cimetidine, which is an inhibitor of microsomal liver enzymes.

With simultaneous use with ethyl estrenol, anticoagulant effect increases, there is a risk of bleeding.

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