Generic Name: Acenocoumarol Brand Name(s): Acenocoumarol.


What is acenocoumarol used for?

Acenocoumarol is commonly used for treating and preventing blood clots in the blood vessels, for example in the following cases:

  • Preventing abnormal blood clots in conditions with increased risk, e.g., rheumatic heart disease, atrial fibrillation and after insertion of artificial (prosthetic) heart valves.
  • Treating and preventing blood clots in the veins of the leg (deep vein thrombosis).
  • Treating and preventing blood clots that have travelled to the lungs (pulmonary embolism).

How should I take acenocoumarol?

The tablets can be taken either with or without food. They should be swallowed whole with a drink of water.

If you forget to take a dose at your usual time take it as soon as you remember, unless it is nearly time for your next dose. In this case leave out the missed dose and take your next dose as usual when it is due. Do not take a double dose to make up for a missed dose.

Keep taking this medicine every day as directed until your doctor tells you to stop.

How do I store acenocoumarol?

Acenocoumarol is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store acenocoumarol in the bathroom or the freezer. There may be different brands of acenocoumarol that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush acenocoumarol down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using acenocoumarol?

Before using this drug, tell your doctor if:

  • You are pregnant or breastfeeding. This is because, while you are expecting or feeding a baby, you should only take medicines on the recommendation of a doctor.
  • You are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • You have allergy with any of active or inactive ingredients of acenocoumarol or other medications.
  • You have any other illnesses, disorders, or medical conditions.

You should take extra care when participating in physical activities while taking this medicine, as even minor injury may result in bruising or bleeding.

As this medicine prevents blood clotting, too much can increase your risk of bleeding. On the other hand, too little will not be effective at preventing clotting. It is therefore important that you have regular blood tests to monitor your blood clotting time (INR) so that your dose can be altered if necessary. When first starting treatment this test should be daily or on alternate days, and as your INR becomes more stable the tests can be at longer intervals. You will probably need your INR checking after any changes to your acenocoumarol dose, if you become ill suddenly, or if you are prescribed certain other medicines. Talk to your doctor about when your INR will need checking.

Drinking large amounts of alcohol in one go should be avoided while taking acenocoumarol, as this may increase its effect. In contrast, chronic heavy drinking can decrease the effect of acenocoumarol. However, it is fine to drink alcohol now and then in moderation.

As acenocoumarol works by inhibiting the action of vitamin K, changes to your dietary intake of vitamin K can alter the effect of your acenocoumarol. For this reason, avoid making sudden major changes to your diet, particularly your consumption of green tea, salad and green vegetables (e.g., broccoli, brussel sprouts, or spinach), which contain large amounts of vitamin K. Large amounts of green vegetables (more than 500g daily) can reduce the effect of acenocoumarol and should be avoided. Changes to your consumption of fats and oils can also alter the effect of acenocoumarol, as vitamin K is a fat soluble vitamin.

The effects of acenocoumarol may also be altered by other foods, for example cranberry juice should be avoided, as it may increase the effect of acenocoumarol. Acenocoumarol’s effect can also be altered by sudden increases or decreases in your body weight. For these reasons you should avoid making sudden major changes to your diet during treatment with acenocoumarol. For more information, talk to your pharmacist.

Consult your doctor immediately if you experience any bruising, bleeding, dark stools, blood in the urine, vomiting, diarrhea, fever or acute illness while taking this medicine, so that your INR can be checked.

You will be given an anticoagulant treatment booklet when you start treatment with this medicine. This will contain details of your acenocoumarol dose and INR and will also give advice on your anticoagulant treatment. You should carry this with you at all times in case you are involved in an accident.

It is important that you tell any health professional treating you, including your dentist and anyone administering vaccines or other injections, that you are taking this medicine. If you are due to have any surgery it is also important to talk to your doctor in advance about your acenocoumarol. For some surgery it may be safe to keep taking acenocoumarol, whereas if you are going to have major surgery with a higher risk of bleeding your doctor may want you to stop taking your acenocoumarol a few days before the surgery. Follow the instructions given by your doctor.

Use with caution in:

  • Children.
  • People over 65 years of age.
  • People with decreased kidney function.
  • People with decreased liver function.
  • People with severe heart failure.
  • People who are malnourished or who have a disorder affecting the absorption of food from the gut.
  • People with a blood disorder called protein C or protein S deficiency. This would cause you to bleed for longer than normal after a cut or injury.
  • People with cancer.
  • People with infections or inflammation.
  • People with an overactive thyroid gland (thyrotoxicosis).

This drug should not to be used in:

  • People who are allergic to other coumarin anticoagulants, e.g., warfarin.
  • People with blood disorders that increase the risk of bleeding, for example, the blood clotting disorder hemophilia or low numbers of platelets in the blood (thrombocytopenia).
  • People with bleeding in the brain, lungs or urinary tract.
  • People who have had a stroke caused by bleeding in the brain (hemorrhagic stroke).
  • People with a peptic ulcer or bleeding in the gut.
  • People with inflammation or infection around the heart (pericarditis, infective endocarditis, perciardial effusion).
  • People who have recently had or are due to have major surgery or surgery on the brain, spinal cord or eyes.
  • People with very high blood pressure (hypertension).
  • People with severely reduced kidney function.
  • People with severely reduced liver function.
  • Rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorbtion (Sinthrome tablets contain lactose).

Is it safe during pregnancy or breastfeeding?

There isn’t enough information about the safety of using this acenocoumarol during pregnancy and breast-feeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this acenocoumarol.

Side effects

What side effects can occur from acenocoumarol?

Common side effects include:

  • Bleeding and bruising
  • Increased time taken to stop bleeding

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.


What drugs may interact with acenocoumarol?

Acenocoumarol may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Products that interact with this drug are:

  • Antiplatelet or ‘blood thinning’ medicines such as low-dose aspirin, clopidogrel, dipyridamole
  • Apixaban
  • Bivalirudin
  • Dabigatran
  • Duloxetine
  • Fondaparinux
  • The herbal remedy ginko
  • Glycoprotein IIb/IIIa receptor antagonists such as eptifibatide, tirofiban and abciximab
  • Heparin
  • Ketorolac
  • Low molecular weight heparins, eg dalteparin
  • Prasugrel
  • Rivaroxaban
  • SSRI antidepressants such as paroxetine or fluoxetine
  • Venlafaxine

Does food or alcohol interact with acenocoumarol?

Acenocoumarol may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with acenocoumarol?

Acenocoumarol may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.


The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using acenocoumarol.

What is the dose of acenocoumarol for an adult?

This drug should be taken once a day. Take your dose at the same time each day.

The dose that your doctor prescribes will vary from person to person and may vary from day to day. It depends on the condition being treated and your blood clotting time (INR or prothrombin time). You will need to have regular blood tests to check this and your doctor will adjust your dose based on the results. It is important to follow the instructions given by your doctor regarding how many tablets to take each day.

What is the dose of acenocoumarol for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is acenocoumarol available?

Acenocoumarol is available in the following dosage forms and strengths:

  • Tablet

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of acenocoumarol, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.


Review Date: September 12, 2017 | Last Modified: September 13, 2017

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