Aceronko 4 Pharbaco prophylaxis and treatment of pulmonary infarction and heart muscle, deep vein thrombosis (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Acenocoumarol
Ingredient Central Pharmaceutical Joint Stock Company 1 - Pharbaco

Ingredient

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Composition information	Content
Acenocoumarol	4mg

Uses

indications

Aceronko 4 drugs indicated treatment in the following cases:

Heart disease clogged: Preventing vascular blockage due to atrial fibrillation, mitral valve disease, artificial valve. Preventive recurrence of myocardial infarction when it is impossible to use aspirin. whether.

pharmacokinetics

No data.

Before taking Aceronko 4 Pharbaco prophylaxis and treatment of pulmonary infarction and heart muscle, deep vein thrombosis (3 blisters x 10 tablets)

How to use

Aceronko 4 drugs for oral.

Dosage

The dosage must be adjusted to achieve the purpose of preventing blood clotting mechanism that it does not occur but avoiding spontaneous bleeding. Dosage depends on the response of each person. The dose for adults in the first two days is 4 mg/day, drinking in the evening. From the third day, the biological test will allow the determination of treatment dose. This dose usually from 1 to 8mg/day. The adjustment usually conducts each step 1 mg.

Biological monitoring and dose adjustment:

The appropriate biological test is to measure prothrombin (PT) time that is indicated by the International Normalized Ratio). Prothrombin time allows the exploration of factors II, VII, and X are factors that are reduced by vitamin K anti -vitamin K.

INR is a way of denoting the sensitivity of the reagent (Thromboplastin) used for testing, so it should reduce erratic changes between labo.

When not taking anti -vitamin K, Inr in normal people is 1. When taking the drug in the following situations, in most cases the target of the INR needs to be 2.5, fluctuating in the range of 2 and 3. Inr below 2 reflects the use of anticoagulants is not enough. Inr above 3 is to use excess medicine. Inr above 5 is at risk of bleeding.

Biological checkpoints: The first test is done 48 hours 12 after taking the first vitamin K anti -vitamin drug to detect an increase in an increase in individual sensitivity. If INR above 2, signaling will overdose when balanced, so the dose should be reduced. The second test usually conducts 3-6 days later. The following tests conducted 2-4 days until the Inr stabilized, then gradually far away, the longest was once a month.

Balance of treatment sometimes only reaches after weeks. After each dose change, check the INR 2 - 4 days later and repeat until stable.

In general, Inr from 2-3 is recommended to prevent venous thrombosis, including pulmonary embolism, atrial fibrillation, heart valve, or biological valve. Inr from 2.5 to 3.5 is recommended after myocardial infarction, mechanical valve patients, or in some patients with thrombosis or phospholipid syndrome. Higher Inr can be recommended for recurrent clogged.

Dosage for children: Experience in using anticoagulants for children is limited, starting and monitoring must be conducted at specialized facilities.

Avoid using anticoagulants for breastfeeding children under 1 month of age. The average dose when equilibrium to achieve INR is from 2 to 3 depending on age and weight: in children over 3 years old, the dose is calculated according to the weight of the adult.

Starting dose for children Dosage in the elderly: The starting dose must be lower than the adult dose. The average balance dose in treatment is usually only 1/2 to 3/4 of adult dose.

Serial treatment of heparin-therapy: Due to the slow anticoagulant effect of vitamin K anti-vitamin drugs, heparin must be maintained with constant doses throughout the necessary time, that is, until the INR is in the desired value for 2 consecutive days. In case of heparin platelets, vitamin K should not be given soon after heparin stops because there is a risk of hyper coagulation due to protein S (anticoagulant) early. Only vitamin K resistance after giving thrombin drugs (Danaparoid or Hirudine).

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when using overdose?

What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

Side Effects

The most common complications of bleeding, which can occur all over the body:

The central nervous system, limbs, viscera, in the abdomen, in the eyeball, ...

Sometimes diarrhea occurs (may be accompanied by fatty fertilizer), individual joint pain. localized skin necrosis, possibly due to genetics lacking C protein or homogeneous factor is S protein; Allergic skin.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Aceronko 4 contraindicated drug in the following cases:

Hypersensitivity has known to the Coumarin derivatives or the ingredients in the drug. ml/minute.

Be cautious when using

Must pay attention to the cognitive ability of the patient during the treatment process (the risk of wrong medication). Careful guidance for them to comply with accurate indications, understanding the risk and attitude of handling, especially for the elderly.

Must emphasize the daily medication at the same time.

Must biological testing (INR) periodically and at the same place.

In case of surgical intervention, each case must be considered to adjust or suspend anticoagulic drugs, based on the risk of patient thrombosis and the risk of bleeding associated with each type of surgery.

carefully monitor and adjust the dose accordingly in people with liver failure, kidney failure or lower blood protein.

Hemorrhagic complications occur in the first months of treatment, so it is necessary to monitor closely, especially when the patient is discharged home.

Using drugs for women during pregnancy and lactation

has statistics of about 4% of the fetal deformity when the mother uses this drug in the first quarter of pregnancy. In the next quarters, there is still risk (including miscarriage). So only use the drug when it is impossible for heparin.

Avoid breastfeeding. If you have to breastfeed, you should compensate for vitamin K for the child.

The effect of the drug on the ability to drive and operate machinery

No report on the effect of drugs on driving and operating machinery.

Interactive drug

A lot of drugs can interact with vitamin K anti -vitamin drugs, so they need to monitor patients 3-4 days after adding or removing combined drugs.

contraindicated coordination:

Aspirin (especially with high doses of over 3 g/day) increases anticoagulant effects and the risk of bleeding due to platelet aggregation inhibits and transferring anticoagulant oral fluids from bonding with plasma proteins.

Miconazole: Unexpected hemorrhage can be severe due to increased blood in the blood and inhibit the metabolism of anti -vitamin K drugs.

Phenylbutazon increases anticoagulant effects combined with the gastrointestinal mucosa irritation.

Non -steroid anti -inflammatory drugs, pyrazol groups: Increased risk of bleeding due to platelet inhibition and gastrointestinal mucosa irritation.

Do not coordinate:

Aspirin with doses under 3g/day.

Non-steroid anti-inflammatory drugs, including COX-2 inhibitors.

chloramphenicol: Increases the effect of anticoagulant oral medications due to reducing this drug in the liver. If it is not possible to avoid coordination, you must check the Inr more often, adjust the dose in and after 8 days of stopping chloramphenicol.

diflunisal: Increases the effect of anticoagulant oral medications due to competition associated with plasma proteins. Other painkillers should be used, for example paracetamol.

Precautions when coordinating:

Allopurinol, aminoglutetimid, amiodaron, androgen, antidepressants Serotonin, Benzbromaron, Bosentan, Carbamazepin, Cephalosporin, Cimetidin (above 800 mg/day), Cisaprid, Colestyramin, Corticoid (except Hydrocortison used to replace substance in Addisane) Cyclin, cytotoxic drugs, cibrat, mushroom Azol, fluoroquinolon, heparin, thyroid hormones, enzyme induction drugs, statins, macrolids (except for spiramycin), neviparin, efavirenz, imidazol group, orlistat, pentoxifyllin, phenytoin, phenyon, procedoneon, propafenon, procedafenon Ritonavir, Lopinavir, some sulfamids (sulfametoxazol, sulfafurazol, sulfamethizol), sucralfate, cancer medicine (tamoxifen, raloxifen), tibolon, vitamin E above 500 mg/day, alcohol, anti -cubic supplies, blood pepper, etc.

Storage

Where dry, less than 300C.

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