Chemical formula: C₁₅H₁₀O₂ Molecular mass: 222.239 g/mol PubChem compound: 4760
Phenindione interacts in the following cases:
Oral anticoagulant therapy is contraindicated in pregnancy because of possible teratogenicity and the risk of foetal haemorrhage near term.
It is suggested that heparin, which does not cross the placenta, can be used during the first trimester and after 37 weeks of gestation. However, the use of heparin during pregnancy is not absolutely safe and specialist guidance should be obtained for patients who are pregnant and who need anticoagulant therapy.
Women of child-bearing age who are treated with phenindione should be cautioned about the possible complications of pregnancy.
As phenindione is distributed into breast milk, infants should not be fed with breast milk from mothers being treated with phenindione.
Phenindione has no or negligible influence on the ability to drive or use machines.
Adverse reactions are ranked under heading of frequency, the most frequent first, using the following convention: Very common: (≥1/10); Common (≥1/100 to <1/10); Uncommon (≥1/1,000 to <1/100); Rare (≥1/10,000 to <1/1,000); Very rare (<1/10,000); Not known: cannot be estimated from the available data.
The following undesirable effects have been reported:
Not known: Fever
Not known: leucopenia; agranulocytosis*; lymphadenopathy*; eosinophilia*; Leukocytosis*; Pancytopenia*; leukaemoid syndrome*
Not known: Hypersensitivity
Not known: Cerebral haemorrhage; cerebral subdural haematoma
Not known: Haemorrhage
Not known: Haemothorax, epistaxis
Not known: Gastrointestinal haemorrhage, rectal haemorrhage, haematemesis; pancreatitis; diarrhoea; nausea; vomiting; melaena; Dysgeusia
Not known: Hepatitis, jaundice*
Not known: rash*, purpura; Blue toe syndrome; ecchymosis; alopecia*; skin necrosis*; dermatitis exfoliative*, exanthema.
Not known: Haematuria; renal damage with tubular necrosis*; albuminuria*
Not known: haematocrit decreased; haemoglobin decreased
* These events have been reported in relation to hypersensitivity reactions. If any of the above effects are found, phenindione therapy should be stopped immediately, and a full investigation of blood, liver and renal function should be undertaken. Possible sensitivity to other drugs should be considered. Other anticoagulants, such as warfarin, are tolerated usually by patients sensitive to phenindione.
An episode of bleeding during anticoagulant therapy must be investigated fully and not regarded automatically as a manifestation of overdosage. The metabolites of phenindione often colour the urine pink or orange. This effect may be distinguished from discoloration caused by haemoglobin by the addition of a few drops of dilute acetic acid to the urine. If the discoloration is due to phenindione, the discoloration will disappear immediately.
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