Therapeutic indications

Acenocoumarol is indicated for:

Treatment and prevention of thromboembolic diseases

Irrespective of gender only Adults (18 years old or older)

Treatment and prevention of thromboembolic diseases.

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Oral - 1-8 mg once a day


Active ingredient Acenocoumarol is contraindicated in the following cases:


Acenocoumarol is contraindicated in haemorrhage in the gastro-intestinal tract, urogenital tract or respiratory system; cerebrovascular haemorrhages.

Severe hypertension

Acenocoumarol is contraindicated in severe hypertension (due to occult risks).

Surgery on the central nervous system or eyes and traumatising surgery

Acenocoumarol is contraindicated immediately prior to, or after surgery on the central nervous system or eyes and traumatising surgery involving extensive exposure of the tissues.

Peptic ulceration

Acenocoumarol is contraindicated in peptic ulceration.

Cranberry juice

Cranberry juice should be avoided in patients receiving acenocoumarol due to a theoretical risk of enhanced anti-coagulation. Increased medical supervision and INR monitoring should be considered for any patient receiving acenocoumarol and regularly drinking cranberry juice. It is not known whether other cranberry products, such as capsules or concentrates, might also interact with acenocoumarol. Therefore similar caution should be observed with these products.

Severe renal disease

Acenocoumarol is contraindicated in severe renal disease.

Severe hepatic disease

Acenocoumarol is contraindicated in severe hepatic disease.

Heparin, platelet-aggregation inhibitors, pyrazolone derivatives and NSAIDs

Drugs altering haemostasis may potentiate the anticoagulant activity of acenocoumarol and thereby increase the risk of haemorrhage. Consequently, acenocoumarol should not be prescribed with such drugs, which include: heparin (including low-molecular-weight heparin), platelet-aggregation inhibitors (e.g. dipyridamole, clopidogrel), salicyclic acid and its derivatives, acetylsalicylic acid, para-aminosalicylic acid, diflunisal, phenylbutazone or other pyrazolone derivatives (e.g. sulfinpyrazone), and other non-steroidal anti-inflammatory drugs (NSAIDs) including COX-2 inhibitors (e.g. celecoxib), high dose IV methylprednisolone.

Vitamin K deficiency

Acenocoumarol is contraindicated in vitamin K deficiency.

Acute pericarditis, pericardial effusion, infective endocarditis

Acenocoumarol is contraindicated acute pericarditis, pericardial effusion, infective endocarditis.

Acute pancreatitis

Acenocoumarol is contraindicated in acute pancreatitis.

Threatened abortion

Acenocoumarol is contraindicated in threatened abortion.

Patients unable to co-operate

Acenocoumarol is contraindicated in patients unable to co-operate (e.g. unsupervised and senile patients, alcoholics and patients with psychiatric disorders).


Acenocoumarol passes into the breast milk of lactating mothers, but in quantities so small that no undesirable effects on the infant are to be expected. However, as a precaution, the infant should be given 1mg vitamin Κ1 per week as a prophylactic measure.

The decision to breast-feed should be carefully considered and may include coagulation tests and vitamin K status evaluation in infants before advising women to breast-feed. Women who are breast-feeding and treated with Sinthrome should be carefully monitored to ensure that recommended PT/INR values are not exceeded.


Acenocoumarol, like other coumarin derivatives, may be associated with congenital malformations of the embryo, therefore it is contra-indicated for use in pregnancy. Women of child-bearing potential should take contraceptive measures during treatment with acenocoumarol.

Cases of increased fibrinolytic activity

Acenocoumarol is contraindicated in cases of increased fibrinolytic activity following operations on the lung, prostate or uterus.

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