Marcumar
Marcumar - General Information
Coumarin derivative that acts as a long acting oral anticoagulant. [PubChem]
Pharmacology of Marcumar
Marcumar, a coumarin anticoagulant, thins the blood by antagonizing vitamin K which is required for the production of clotting factors in the liver. Anticoagulants such as phenprocoumon have no direct effect on an established thrombus, nor do they reverse ischemic tissue damage (damage caused by an inadequate blood supply to an organ or part of the body). However, once a thrombus has occurred, the goal of anticoagulant treatment is to prevent further extension of the formed clot and prevent secondary thromboembolic complications which may result in serious and possibly fatal sequelae.
Marcumar for patients
The objective of anticoagulant therapy is to decrease the clotting ability of the blood so that thrombosis is prevented, while avoiding spontaneous bleeding. Effective therapeutic levels with minimal complications are in part dependent upon cooperative and well-instructed patients who communicate effectively with their physician. Patients should be advised: Strict adherence to prescribed dosage schedule is necessary. Do not take or discontinue any other medication, including salicylates (e.g., aspirin and topical analgesics), other over-the-counter medications, and botanical (herbal) products (e.g., bromelains, coenzyme Q10, danshen, dong quai, garlic, Ginkgo biloba, ginseng, and St. John's wort) except on advice of the physician. Avoid alcohol consumption. Do not take phenprocoumon during pregnancy and do not become pregnant while taking it. Avoid any activity or sport that may result in traumatic injury. Prothrombin time tests and regular visits to physician or clinic are needed to monitor therapy. Carry identification stating that phenprocoumon is being taken. If the prescribed dose of phenprocoumon is forgotten, notify the physician immediately. Take the dose as soon as possible on the same day but do not take a double dose of phenprocoumon the next day to make up for missed doses. The amount of vitamin K in food may affect therapy with phenprocoumon. Eat a normal, balanced diet maintaining a consistent amount of vitamin K. Avoid drastic changes in dietary habits, such as eating large amounts of green leafy vegetables. Contact physician to report any illness, such as diarrhea, infection or fever. Notify physician immediately if any unusual bleeding or symptoms occur. Signs and symptoms of bleeding include: pain, swelling or discomfort, prolonged bleeding from cuts, increased menstrual flow or vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or dark brown urine, red or tar black stools, headache, dizziness, or weakness. If therapy with phenprocoumon is discontinued, patients should be cautioned that the anticoagulant effects of phenprocoumon may persist for about 2 to 5 days.
Marcumar Interactions
Marcumar Contraindications
Anticoagulation is contraindicated in any localized or general physical condition or personal circumstance in which the hazard of hemorrhage might be greater than the potential clinical benefits of anticoagulation, such as pregnancy and hemorrhagic tendencies or blood dyscrasias.
Additional information about Marcumar
Marcumar Indication: Used for the prevention and treatment of thromboembolic disease including venous thrombosis, thromboembolism, and pulmonary embolism as well as for the prevention of ischemic stroke in patients with atrial fibrillation (AF).
Mechanism Of Action: Marcumar inhibits vitamin K reductase, resulting in depletion of the reduced form of vitamin K (vitamin KH2). As vitamin K is a cofactor for the carboxylation of glutamate residues on the N-terminal regions of vitamin K-dependent proteins, this limits the gamma-carboxylation and subsequent activation of the vitamin K-dependent coagulant proteins. The synthesis of vitamin K-dependent coagulation factors II, VII, IX, and X and anticoagulant proteins C and S is inhibited. Depression of three of the four vitamin K-dependent coagulation factors (factors II, VII, and X) results in decreased prothrombin levels and a decrease in the amount of thrombin generated and bound to fibrin. This reduces the thrombogenicity of clots.
Drug Interactions: Not Available
Food Interactions: Not Available
Generic Name: Phenprocoumon
Synonyms: Fenprocumone [DCIT]; Phenprocoumarol; Phenprocoumarole; Phenprocoumone; Phenprocumone
Drug Category: Anticoagulants
Drug Type: Small Molecule; Approved
Other Brand Names containing Phenprocoumon: Falithiom; Falithrom; Fencumar; Liquamar; Marcoumar; Marcumar; Marcuphen;
Absorption: Bioavailability is close to 100%
Toxicity (Overdose): 50=500 mg/kg. Symptoms of overdose includes suspected or overt abnormal bleeding (e.g., appearance of blood in stools or urine, hematuria, excessive menstrual bleeding, melena, petechiae, excessive bruising or persistent oozing from superficial injuries).
Protein Binding: 99%
Biotransformation: Phenprocoumon is stereoselectively metabolized by hepatic microsomal enzymes (cytochrome P-450) to inactive hydroxylated metabolites (predominant route) and by reductases to reduced metabolites. Cytochrome P450 2C9 is the principal form of human liver P-450 responsible for metabolism.
Half Life: 5-6 days
Dosage Forms of Marcumar: Not Available
Chemical IUPAC Name: 2-hydroxy-3-(1-phenylpropyl)chromen-4-one
Chemical Formula: C18H16O3
Phenprocoumon on Wikipedia: https://en.wikipedia.org/wiki/Phenprocoumon
Organisms Affected: Humans and other mammals