Features of the use of the indirect anticoagulant phenylin. Medicinal reference book geotar Indications for use Phenilin

Some facts about the product:

Instructions for use

Price in online pharmacy website: from 35

Composition and release form of the drug

The drug Phenilin is available in the form of standard tablets. The original tablets are light or cream in color. The average price of Fenilin is 100 rubles. You can buy Phenilin at any pharmacy without providing a prescription. The main components of the medicine: Phenindione; Citric acid; Milk sugar; Talc; Starch

Pharmacological action

Doctors classify this drug as a coagulant with an indirect effect on the patient’s body. It also improves blood clotting. After using this remedy, patients feel positive changes in blood circulation. The first therapeutic effect appears 9 hours after using this product. The full effect appears after approximately 26 hours. The medicine is absorbed immediately after use, and almost in full. The main components tend to gradually accumulate in tissues. The drug releases a metabolite in the liver. Both the original components and the metabolite are excreted by the kidneys.

Indications

The presence of the following ailments and circumstances is an indication for the use of the drug: Thrombosis at any stage. This drug is also prescribed as an effective preventive measure in case of an increased likelihood of thrombosis in the patient; The period after surgery (if there is a risk of thrombosis); Thrombophlebitis; Embolic type injuries; Complications after myocardial infarction; Strokes (except hemorrhagic).

Contraindications

According to the official instructions for use, the original medicine and the main analogues of Phenilin are contraindicated when: The patient's prothrombin level is below 70%; Not prescribed during menstruation; The patient has diseases that accelerate the process of blood clotting; Pericarditis; Serious problems with the kidneys and liver; Pathology of malignant type; Stomach ulcer.

Dosage

Before using the medicine, it is recommended to read the official description. Violation of the recommended dose may harm the patient's health. The standard dose on the first day is from 0.12 to 0.18 grams. It is necessary to stretch it into three or four doses. Then the dose is reduced to 0.9-0.15 grams. Next, it is necessary to adjust the course of treatment depending on changes in laboratory parameters. Concomitant use of the drug with heparin may be prescribed. The entire course of treatment must be carried out under full medical supervision. The course should be stopped gradually.

Side effects

If you are intolerant to one of the components in the composition, various allergic reactions may occur. Patients also note the appearance of discomfort in the abdomen and fever (in rare cases).

Phenindione

Composition and release form of the drug

20 pcs. - cans (1) - cardboard packs
20 pcs. - contour cell packaging (1) - cardboard packs
50 pcs. - cans (1) - cardboard packs.

Pharmacological action

Allergic reactions: skin rash, dermatitis, eosinophilia, fever.

Drug interactions

When used simultaneously with ACTH, the anticoagulant effect is enhanced.

When used simultaneously with, cases of increased bleeding are described, apparently due to a decrease in platelet adhesiveness and aggregation under the influence of dipyridamole.

When used simultaneously with clofibrate, the anticoagulant effect is enhanced. It is believed that fibrates may increase the affinity of oral anticoagulants for the corresponding receptors or possibly interfere with the metabolism of anticoagulants.

When used simultaneously with liothyronine, the anticoagulant effect of phenindione is enhanced. It is believed that thyroid hormones can increase the affinity of oral anticoagulants for the corresponding receptors.

When used simultaneously with miconazole, the anticoagulant effect of phenindione is enhanced. The risk of bleeding increases.

When used simultaneously, the anticoagulant effect of phenindione is enhanced due to a slowdown in its metabolism in the liver under the influence of cimetidine, which is an inhibitor of microsomal liver enzymes.

When used simultaneously with ethylestrenol, the anticoagulant effect is enhanced and there is a risk of bleeding.

Special instructions

The drug should be used with caution in elderly patients, with hepatic and/or pulmonary embolism (including in oncology), erosive and ulcerative lesions of the gastrointestinal tract, with pericarditis, in the postpartum period.

Treatment should be carried out under close medical supervision with mandatory systematic testing of prothrombin and other coagulation factors in the blood. General urine tests are systematically performed for early detection of hematuria.

Some patients experience orange discoloration of the palms and pink discoloration of the urine, which is associated with the metabolism of phenindione.

Pregnancy and lactation

Contraindicated during pregnancy. Avoid use in the first days after birth.

Phenindione should not be used during lactation (breastfeeding).

Phenindione should be discontinued 2 days before and not used during menstruation.

For impaired renal function

The drug should be used with caution in case of renal failure.

For liver dysfunction

The drug should be used with caution in case of liver failure.

Use in old age

The drug should be used with caution in elderly patients.

Preparation Fenilin- antithrombotic agent.
A drug that affects blood clotting and platelet function. Indirect anticoagulant.
The mechanism of action is due to competitive antagonism with vitamin K. Phenindione blocks vitamin K reductase, disrupts the formation in the liver of the active form of vitamin K, necessary for the synthesis of prothrombin and other blood coagulation factors (VII, IX and X). Causes hypoprothrombinemia.
Reduces plasma tolerance to heparin, blood lipid levels and increases vascular permeability.
The hypocoagulant effect (decrease in the concentration of coagulation factors in the blood) develops gradually (previously synthesized factors of the blood coagulation system continue to act), begins to appear after 8-10 hours and reaches a maximum 24-36 hours after administration. Duration of action is 1 - 4 days after discontinuation of the drug.

Pharmacokinetics

.
After oral administration, it is quickly and almost completely absorbed. The connection with proteins is fragile. Passes through histohematic barriers (including placental) and accumulates in tissues. Metabolized in the liver with the participation of cytochrome P-450. It is excreted by the kidneys unchanged and in the form of metabolites. Can accumulate.

Indications for use

Preparation Fenilin used for the prevention and treatment of thrombosis (especially deep veins of the lower extremities), thromboembolic complications (pulmonary embolism, embolic strokes, myocardial infarction, etc.) and thrombus formation in the postoperative period; mechanical prosthetic heart valves (permanent use).

Directions for use

Fenilin prescribed to adults and adolescents (over 14 years of age with a body weight of at least 45 kg; rarely prescribed) orally after meals.
The optimal dose in different patients can vary significantly and depends on individual sensitivity, the nature of the disease, dietary habits and concomitant treatment, as a result of which the selection of the dose is individual.
Adults are prescribed on the first day of treatment in a daily dose of 120 - 180 mg (4 - 6 tablets) in 3 - 4 doses, on the second day - in a daily dose of 90 - 150 mg (3 - 5 tablets), then - 30 -
60 mg (1 - 2 tablets) in 1 - 2 doses, depending on the level of prothrombin in the blood.
Adolescents over 14 years of age (body weight at least 45 kg) are prescribed (rarely) on the first and second days of treatment at a daily dose of 90 - 150 mg (3 - 5 tablets) in 3 - 4 doses, then - 30 - 60 mg (1 - 2 tablets) in 1 - 2 doses, depending on the level of prothrombin in the blood.
The single dose, frequency and duration of use are set individually by the doctor depending on the value of the prothrombin index in the blood, which is maintained at 40 - 60%. If the prothrombin level is less than 40 - 50%, the drug should be discontinued immediately.
To prevent thromboembolic complications, 30 mg (1 tablet) is prescribed 1 to 2 times a day.
Higher doses for adults: single - 50 mg, daily - 200 mg.
The drug should be discontinued gradually.

Side effects

From the blood coagulation system: with long-term use - micro- and macrohematuria, bleeding from the oral cavity and nasopharynx, gastrointestinal bleeding, hemorrhage into the muscles. From the blood system: inhibition of bone marrow hematopoiesis (agranulocytosis, leukopenia, leukemoid reactions). From the digestive system: nausea, diarrhea, toxic hepatitis. From the cardiovascular system: myocarditis. Allergic reactions: skin rash (erythematous, macular, papular), exfoliative dermatitis, eosinophilia, hyperthermia. From the urinary system: impaired renal function, pink colored urine. Other: headache, orange discoloration of palms.

Contraindications

Contraindications to the use of the drug Fenilin are: increased individual sensitivity to the components of the drug, hemophilia, severe liver and/or renal failure, hemorrhagic diathesis, hypocoagulation (initial prothrombin level less than 70%), malignant neoplasms, erosive and ulcerative lesions of the gastrointestinal tract, pregnancy (especially the first trimester and the second half of the third trimester), the period of breastfeeding, childhood.

Pregnancy

Preparation Fenilin contraindicated during pregnancy (especially in the first trimester and the second half of the third trimester). The drug should not be used in the first days after childbirth. If use is necessary during lactation, breastfeeding should be discontinued.

Interaction with other drugs

Effect of the drug Fenilin enhance thrombolytic, antiaggregation agents, anticoagulants, adrenocorticotropic hormone, anabolics, azathioprine, allopurine, amiodarone, narcotic analgesics, androgens, antibiotics, tricyclic antidepressants, urinary oxidizing agents, glucocorticosteroids, diazoxide, disopyramide, nalidixic acid, isoniazid, clofibrate, angry, paracetamol, reserpine, vitamin E, butadione, sulfonamides, disufiram, quinidine, cyclophosphamide, thyroid hormones, cimetidine and other microsomal oxidation inhibitors.

The effect of the drug is weakened by vitamin K, propranolol, urine alkalinizers, antacids, cholestyramine, phenazone, haloperidol, diuretics, carbamazepine, barbiturates, oral contraceptives, rifampicin.

Overdose

Overdose symptoms Fenilina: hemorrhagic syndrome (gastrointestinal, uterine, nosebleeds, hematuria, hemorrhages in the skin, muscles, parenchymal organs). Treatment: drug withdrawal; taking vitamin K orally (5 - 10 mg). If serious bleeding develops, vitamin K is administered intravenously slowly (1 mg/min) in a total dose of 10–50 mg (normalizes the increased prothrombin time within 6 hours). In case of massive bleeding or in patients with liver failure, fresh frozen plasma is prescribed at the same time. It is possible to use aminocaproic acid, vitamins C and P.

Storage conditions

Store in a place protected from light at temperatures from 8 °C to 25 °C. Keep out of the reach of children.
Shelf life - 3 years.

Release form

Phenilin - tablets 30 mg.
No. 20 in a blister in a box.

Compound:
1 tablet Fenilin contains phenyline (phenindione) 30 mg.
Excipients: lactose monohydrate, potato starch (in terms of starch with a moisture content of 10%), talc, citric acid monohydrate.

Additionally

Prescribe the drug with caution Fenilin in old age (increased risk of bleeding, especially intracranial), with liver and/or renal failure, increased vascular permeability, pericarditis, in the postpartum period, with gynecological diseases.
For acute thrombosis, it is prescribed together with heparin.
During the course of treatment with the drug, systematic monitoring of the prothrombin ratio (normal values ​​are 2.0 - 4.0), regular extended coagulation blood tests (coagulogram, thromboelastogram, platelet count), and urine analysis for early detection of hematuria are necessary.
To monitor anticoagulation activity, the prothrombin time indicator is used: reliable prevention of venous thrombosis is achieved by increasing the prothrombin time by 2 times, the arterial time by 3-4 times (the norm is 11-14 sec).
The drug should not be prescribed during menstruation (stop taking it 2 days before it starts) and in the first days after childbirth.
The coloring of urine pink and the palms orange is due to the metabolism of phenindione (transition to the enol form) and is not dangerous. When urine is acidified, the pink color disappears, which can be used to differentiate urine staining from hematuria. If the palms are stained and the color of urine changes, it is recommended to replace the drug with another anticoagulant, with the exception of omefin.
Impact on the ability to drive vehicles and machinery. During the treatment period, you should refrain from driving vehicles and engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Basic parameters

Name:	PHENILIN
ATX code:	B01AA02 -

Anticoagulant therapy in the prevention of systemic embolization in patients with rheumatic heart disease and atrial fibrillation. Prevention after heart valve replacement. Prevention and treatment of venous thrombosis and pulmonary embolism.

Contraindications

Hypersensitivity to phenindione and other components of the drug; hemorrhagic stroke; clinically significant bleeding; within 72 hours after surgery with a risk of severe bleeding, within 48 hours after childbirth; pregnancy; breastfeeding; children under 14 years of age; simultaneous use with medications that increase the risk of bleeding. Phenindione should not be prescribed to patients with severe renal or hepatic impairment, bacterial endocarditis, uncontrolled hypertension, actual or potential hemorrhagic conditions, or to patients with hereditary galactose intolerance, lactase deficiency or glucose-galactase malabsorption.

Cautions for use

Most adverse events associated with phenindione are the result of allergic reactions or anticoagulant effects, so it is important that the need for therapy is reviewed by a physician on a regular basis and should be discontinued when it is no longer required. Patients should be aware of the symptoms of adverse reactions and that they should contact their physician if any signs of adverse effects are observed.

Conditions in which the effect of phenindione may be enhanced, requiring dosage reduction, include weight loss, old age, acute illness, impaired renal function, reduced dietary intake of vitamin K, and taking certain medications (see Interactions section).

Conditions that may reduce the effect of phenindione and may require increased dosage include weight gain, diarrhea and vomiting, increased intake of vitamin K, fats or oils, and certain medications (see Interactions section).

When treating with phenindione using a standard dosage regimen, the INR should be determined daily or every other day in the first days of treatment. Once the INR has stabilized in the target range, the INR can be determined at longer intervals. INR should be monitored more frequently in patients at increased risk, such as patients with severe hypertension, hepatic or renal impairment, and in patients for whom dosage compliance may be difficult.

Thrombophilia. Patients with protein C or protein S deficiency are at risk; it is advisable to select the dose of phenindione for them individually.

Risk of bleeding. The most common side effect of all oral anticoagulants is hemorrhage. Phenindione should be administered with caution to patients at risk of serious bleeding (eg, concomitant use of nonsteroidal anti-inflammatory drugs, ischemic stroke, bacterial endocarditis, history of gastrointestinal bleeding). Risk factors for bleeding include high intensity anticoagulation (INR > 4.0), age ≥ 65, highly variable INR, history of gastrointestinal bleeding, uncontrolled hypertension, cerebrovascular disease, cardiac disease, orthostatic hypotension, anemia, malignancy, trauma, renal failure, concomitant use of drugs (see section “Interaction”).

In patients with a high risk of bleeding, it is necessary to monitor the INR more frequently, carefully adjust the dose of the drug until the desired INR is achieved, and reduce the duration of therapy as much as possible. Patients should be instructed to minimize the risk of bleeding and to immediately report signs and symptoms of bleeding to their physician. Any concomitant antiplatelet drugs should be used with caution due to the increased risk of bleeding.

Bleeding. Bleeding may indicate an overdose of phenindione (see section “Overdose”). In case of unexpected bleeding, INR monitoring is necessary, and a bleeding episode during anticoagulant therapy should be fully investigated and not automatically considered a manifestation of overdose.

Ischemic attack. Anticoagulant therapy; following an ischemic stroke, increases the risk of secondary hemorrhage in the brain with infarction. In patients with atrial fibrillation, long-term use of phenindione is necessary, but there is a small risk of early recurrence of embolism, so a break in treatment after an ischemic stroke is justified. Treatment with phenindione should be resumed 2-14 days after an ischemic stroke, depending on the size of the infarct area and blood pressure. In patients with large embolic strokes or uncontrolled hypertension, treatment should be stopped for 14 days.

Surgery. For surgical interventions without the risk of severe bleeding, the operation can be performed at the INR

Administration of vitamin K may result in the patient developing resistance to the action of phenindione within a few days. Therefore, when bleeding in patients with prosthetic heart valves, it is necessary to administer fresh frozen plasma.

Dentistry. Phenindione may not be stopped until after routine dental surgery, such as a tooth extraction.

Active peptic ulceration. Due to the high risk of bleeding, phenindione should be used with extreme caution in patients with active peptic ulcer disease. Such patients should be under regular medical supervision and be taught how to recognize bleeding and what to do if bleeding occurs.

Thyroid diseases. Patients with hyper- or hypothyroidism should be carefully monitored, especially when initiating anticoagulation therapy.

Dosage adjustment of phenindione may be required in cases of acquired or hereditary resistance to phenindione, which should be considered if larger than usual daily doses are required to achieve the desired anticoagulant effect.

The effectiveness of phenindione may be significantly influenced by genetic variation especially in relation to VKORC1 (vitamin K reductase). If a patient has a family association with this polymorphism, additional monitoring is necessary for such patients.

Interaction with othershymic drugs

During therapy with phenindione, careful monitoring of all patients taking concomitant therapy is necessary. Any new concomitant therapy should be consulted for specific instructions on dosage adjustments of phenindione. The need for increased coagulation monitoring should be considered with any new treatment regimen if there is any doubt about the extent of the interaction.

.Drugswhich are contraindicated during therapyphenindione

Concomitant use of drugs used in the treatment or prevention of thrombosis, or other drugs with negative effects on hemostasis, may increase the effect of phenindione, which increases the risk of bleeding. Fibrinolytic drugs such as streptokinase and alteplase are contraindicated in patients receiving phenindione.

Drugs that are taken foropportunity should be avoided

The following drugs should be avoided or used with caution with increased clinical and laboratory monitoring: clopidogrel; NSAIDs (including aspirin and COX-2 specific NSAIDs); sulfinpyrazone; thrombin inhibitors such as bivalirudin, dabigatran; dipyridamole; unfractionated heparins and heparin derivatives, low molecular weight heparins; fondaparinux, rivaroxaban; glycoprotein IIb/IIIa receptor antagonists such as epifibatide, tirofiban and abciximab; prostacyclins; antidepressants from the group of serotonin reuptake inhibitors; clofibrate; miconazole; cytostatics; other drugs that inhibit hemostasis, coagulation or platelet action.

Low-dose aspirin with phenindione may be therapeutic in some patients but increases the risk of gastrointestinal bleeding.

Drugs that have clinically significant interactions withphenindione

The action of phenindione is potentiated by ACTH, allopurinol, amitriptyline/nortriptyline, cimetidine, dextropoxyphene, glucagon, hepatotoxic drugs, phenformin, thyroid compounds, tolbutamide, disulfiram, amiodarone, propafenone, anabolic steroids, corticosteroids, oral contraceptives, zafirlukast.

The effect of phenindione is reduced by barbiturates, carbamazepine, griseofulvin, and phenytoin. Broad-spectrum antibiotics may enhance the effect of phenindione by inhibiting the intestinal flora that produces vitamin K. In addition, orlistat may reduce the absorption of vitamin K. Cholestyramine and sucralfate potentially reduce the absorption of phenindione.

Increases in INR have been reported in patients taking glucosamine or other anticoagulants (eg, warfarin), and this combination is not recommended. Interaction with plant products

Many herbal products theoretically have an effect on the action of phenindione. Patients should avoid taking any herbal medications or dietary supplements and should tell their doctor immediately if they are taking any herbal medications, as this will require more frequent monitoring.

Interaction with food and food additives

Clinical reports from individual patients suggest a possible interaction between anticoagulants (eg, warfarin) and cranberry juice, in most cases resulting in an increase in INR or bleeding. Increased INR control should be considered for any patient taking phenindione and regularly taking cranberry juice. Certain foods such as liver, broccoli, Brussels sprouts, and green leafy vegetables contain large amounts of vitamin K. Drastic changes in diet may potentially affect anticoagulation control. Patients should be advised (INAUDIBLE) to seek medical advice before undertaking any major dietary changes. Many other dietary supplements have theorized effects of (INAUDIBLE) phenindione, but most of these interactions have not been proven. Patients should avoid taking any dietary supplements while taking phenindione or consult a physician if taking any dietary supplements.

Features of the use of medicinal productsby somecategoriespatients

Applicationin elderly patients

In elderly patients, the effect of phenindione may increase with an increased risk of bleeding, which requires a reduction in the dosage of the drug.

Application during pregnancy and breastfeeding

Oral anticoagulant therapy is contraindicated during pregnancy due to possible teratogenic effects and the risk of fetal bleeding. It is suggested that heparin, which does not cross the placenta, can be used during the first trimester and after 37 weeks of pregnancy, however, the use of heparin during pregnancy is not completely safe and the patient should be advised by a specialist who is skilled in its management. pregnant patients requiring anticoagulant therapy. Women of childbearing age who are treated with phenindione should be warned about possible complications during pregnancy.

Phenindione passes into breast milk; breast milk should not be fed to infants of mothers receiving phenindione.

Impact on the ability to drive vehicles andwork with complex mechanisms

Phenindione has no or negligible effect on the ability to drive or use machines.

Directions for use and doses

Setting the dose the doctor individually takes into account the sensitivity to the drug, nature of care levaniya, indicators of condition with blood coagulation systems and concomitant treatments.

Prescribed orally after meals. The initial loading dose is 180 mg, the next day - 90 mg. On the 3rd day of therapy, the dose is adjusted depending on the results of control tests on the state of the body's coagulation system, such as prothrombin time and international normalized ratio (INR). It should be taken into account that concomitant therapy with heparin affects the results of INR, so the prescription of heparin should be discontinued at least 6 hours before determining the INR. Control tests of the state of the body's coagulation system should be carried out regularly, at regular intervals, and the dose of the drug should be adjusted depending on the results obtained;

The maintenance dose of the drug for most patients is 60-150 mg/day; for resistant patients it can be increased to 180 mg or more, for more sensitive patients it can be reduced.

Overdose

Symptoms of overdose may appear within 48-72 hours, during which the effect of the anticoagulant develops; the onset of bleeding may be delayed for several days.

Symptoms: spontaneous bruising, hematomas, hematuria, rectal bleeding and hemorrhage into any internal organ.

Treatment: The benefit of gastric decontamination is uncertain. In a patient within one hour of ingesting more than 0.25 mg/kg or more, the use of activated charcoal (50 g for adults; 1 g/kg for children) may be considered. Prothrombin time should be monitored sequentially every 24-48 hours after oral administration depending on the initial dose and initial INR.

For patients on long-term phenindione therapy, INR monitoring is required for at least 48 hours after overdose (inaudible)

bleeding, but the prothrombin time is dangerous (MHC > 6.0), you should immediately consult a doctor for rehabilitation measures.

For patients not on long-term phenindione therapy, with a normal INR for 24-48 hours and no signs of bleeding, there is no need for further monitoring. If the patient; consumed more than 0.25 mg/kg or the prothrombin time is significantly increased (INR > 6.0), you should immediately consult a doctor for rehabilitation measures.

Side effect

Side effects are classified as very often - ≥1/10, often - ≥1/100 and

From the hematopoietic system: frequency unknown - leukopenia; agranulocytosis; lymphadenopathy; eosinophilia; leukocytosis; pancytopenia.

From the immune system: frequency unknown - hypersensitivity.

From the nervous system: frequency unknown - cerebral hemorrhage, cerebral subdural hematoma.

Vascular disorders: frequency unknown - bleeding.

From the outsiderespiratorysystems: frequency unknown: hemothorax, nosebleeds.

From the digestive system: frequency unknown - gastrointestinal bleeding, rectal bleeding, hematemesis, pancreatitis, diarrhea, nausea, vomiting, melena, dysgeusia, hepatitis, jaundice.

From the skin and subcutaneous tissue: frequency unknown - rash, purpura, blue finger syndrome, ecchymosis, alopecia, skin necrosis, exfoliative dermatitis, exanthema.

From the outsideurinarysystems: frequency unknown - hematuria; kidney damage with tubular necrosis; albuminuria.

Others: frequency unknown - fever.

Laboratory tests: frequency unknown - decrease in hematocrit, decrease in hemoglobin. Metabolites of phenindione often cause pink or orange-colored urine. This effect can be distinguished from the color change caused by hemoglobin by adding a few drops of dilute acetic acid to the urine. If the color change is due to phenindione, the discoloration will disappear immediately.

What do they say about a drug like Phenilin? Reviews from doctors and patients will be reviewed at the very end of the article. We will also tell you about the purposes for which this drug is prescribed, how to take it correctly, whether it has side effects, analogs and contraindications.

Composition and form

In what form is the drug “Phenilin” produced? The instructions for use indicate that this drug is available in tablets, the active substance of which is phenindione. Milk sugar, starch, citric acid and talc are used as auxiliary ingredients.

Pharmacodynamics

What pharmacological properties does the drug “Phenilin” have? The instructions for use state that this drug has a direct effect on its actions.

Taking the medication contributes to the occurrence of hypoprothrombinemia, which is caused by impaired formation of prothrombin in the liver. This agent also significantly reduces the formation of factors 7, 9 and 10. Moreover, it has a greater cumulative effect compared to neodicoumarin.

After oral administration of tablets, the concentration of blood clotting factors decreases within 8-10 hours. The maximum effect of the drug is observed after 25-30 hours.

Pharmacokinetics

Is the drug "Phenilin" absorbed into the systemic circulation? Reviews from experts say that this medication is characterized by complete and fairly rapid absorption. Its active ingredient penetrates the histo-hematological barriers and accumulates in tissues.

The drug is metabolized in the liver and excreted through the kidneys (in the form of metabolites and unchanged).

Indications for use

For what purpose are Phenilin tablets prescribed? Reviews from experts report that this drug is used for both treatment and prevention. The main indications for use are thrombosis, thrombophlebitis, thromboembolic complications caused by embolic stroke and myocardial infarction, as well as similar disorders.

In addition, the medication in question is often prescribed to prevent blood clots after surgery.

Contraindications for use

Under what conditions of the patient is it prohibited to take the drug "Phenilin"? Instructions for use indicate the following contraindications:

• disorders of the kidneys and liver;
• initial prothrombin level up to 70%;
• increased vascular permeability;
• and other diseases associated with decreased blood clotting;
• peptic ulcers of the gastrointestinal tract;
• malignant neoplasms;
• pericarditis.

It must also be said that the medicine in question is not recommended for use at the very beginning of pregnancy, for several days after childbirth and during menstruation.

The drug "Phenilin": instructions for use

The medication in question is used only for oral administration. Its therapeutic regimen has certain features; therefore, this medicine should be used only as prescribed by a doctor.

The initial daily dose of the drug is usually 0.11-0.17 g (4 times a day). The next day, the amount of the drug is reduced to 0.08-0.14 g, and subsequently to 0.02-0.05 g. After this, the dosage of the tablets depends on the level of prothrombin in the blood.

The maximum amount of the drug at a time should be 0.05 g, and the daily amount should be about 0.2 g.

To prevent thromboembolic complications, it is necessary to take 0.03 g of the drug per day, dividing this dose into two times.

Treatment of acute thrombosis requires additional heparin. This requires strict monitoring by a doctor, as well as a mandatory systematic study of the amount of prothrombin in the blood and other factors of its coagulation.

Treatment with the drug "Phenilin", analogues of which we will list below, is stopped gradually.

Side effects

Does the medication Phenilin cause side effects? The method of use and dosage of this medicine must be strictly followed. This is primarily due to the fact that during therapy the patient may experience various allergic reactions in the form of diarrhea, nausea and hepatitis. Also, according to reviews from doctors and patients, in rare cases, headaches, fever, skin changes, and problems with hematopoiesis are observed.

Signs of overdose

In case of overdose, symptoms may worsen in patients, which are considered side effects. As a treatment for such conditions, mandatory withdrawal of the drug is necessary, as well as immediate intramuscular administration of Vikasol, administration of rutin, or vitamin P, calcium chloride, ascorbic acid, and general symptomatic therapy.

Drug interactions of the drug "Phenilin"

We explained above what this remedy is prescribed for. Let's move on to additional information.

When the drug in question is combined with Heparin, salicylates, Cy-metidine and sulfonamides, their anticoagulant effect may be enhanced. At the same time, anabolic steroids, Allopurinol, Azathioprine, narcotic analgesics, Amiodarone, tricyclic antidepressants, antibiotics, glucocorticosteroids, androgens, Diazoxide, Disopyramide, Isoniazid, androids can increase the effectiveness of Fenilin itself. Butadione, Metronidazole, Clofibrate, Alpha-tocopherol, Reserpine, Quinidine, Paracetamol, Disulfiram, Cyclophosphamide and thyroid hormones.

Vitamin K, Propranolol, ascorbic acid, urine alkalizers, Rifampicin, antacids, Phenazone, Haloperidol, barbiturates, oral contraceptives, diuretics, Meprotan, Carbamazepine and Cholestyramine."

With special caution, this drug is prescribed to elderly patients, as well as people with pulmonary embolism, liver and kidney failure, erosive and ulcerative diseases of the gastrointestinal tract, in the postpartum period and pericarditis.

Treatment with Phenilin must be carried out under the special supervision of a doctor with a mandatory systematic blood test for the amount of prothrombin and other coagulation factors. General urine tests are also performed to detect hematuria early.

In some patients, while taking the drug, urine may turn pink and the palms may turn orange. This is due to the metabolism of phenindione.

The drug "Phenilin": analogues and cost

The main analogues of the drug in question are drugs such as “Varfapex”, “Marevan”, “Neodicoumarin”, etc.

You can purchase the medicine “Phenilin” in the amount of 20 tablets for 120-140 rubles.