Features of the use of the indirect anticoagulant phenylin. Medicinal reference book geotar Indications for use Phenylin
Some facts about the product:
Instructions for use
Price in the online pharmacy site: from 35
Composition and form of release of the drug
The drug Fenilin is available in the form of standard tablets. The original tablets have a light or creamy tint. The average price of Fenilin is 100 rubles. You can buy Fenilin at any pharmacy without a prescription. The main components in the composition of the drug: Phenindione; Lemon acid; milk sugar; Talc; Starch
pharmachologic effect
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 the use of this remedy. The full effect appears after about 26 hours. The drug is absorbed immediately after use, and, moreover, almost in full. The main components tend to gradually accumulate in the 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 remedy is also prescribed as an effective preventive measure with an increased likelihood of thrombosis in a 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 in: The level of prothrombin in a patient is below 70%; Not prescribed during menstruation; The patient has diseases that accelerate the process of blood clotting; Pericarditis; Serious problems in the work of the kidneys and liver; Pathology of malignant type; Gastric ulcer.
Dosage
Before using the medicine, it is recommended to read the official description. Violation of the recommended dose can harm the health of the patient. The standard dose on the first day is from 0.12 to 0.18 grams. It is necessary to stretch it for three or four doses. Further, the dose is reduced to 0.9-0.15 grams. Further, it is necessary to adjust the course of treatment depending on changes in laboratory parameters. Co-administration of the drug with heparin may be prescribed. The entire course of treatment must be carried out under full medical supervision. Stop the course should be gradual.
Side effects
With intolerance to one of the components in the composition, various allergic reactions may occur. Also, patients note the appearance of discomfort in the abdomen and fever (in rare cases).
Phenindione (phenindione)
Composition and form of release of the drug
20 pcs. - cans (1) - packs of cardboard
20 pcs. - blister packs contour (1) - packs of cardboard
50 pcs. - cans (1) - packs of cardboard.
pharmachologic effect
Allergic reactions: skin rash, dermatitis, eosinophilia, fever.
drug interaction
With simultaneous use with ACTH, the anticoagulant effect is enhanced.
With simultaneous use with described cases of increased bleeding, apparently due to a decrease in adhesiveness and platelet aggregation under the influence of dipyridamole.
With simultaneous use with clofibrate, the anticoagulant effect is enhanced. It is believed that fibrates may increase the affinity of oral anticoagulants for their respective receptors or possibly interfere with anticoagulant metabolism.
With simultaneous use with liothyronine, the anticoagulant effect of phenindione is enhanced. It is believed that thyroid hormones can increase the affinity of oral anticoagulants for their respective receptors.
With simultaneous use with miconazole, the anticoagulant effect of phenindione is enhanced. The risk of bleeding increases.
With simultaneous use with, 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.
With simultaneous use with ethylestrenol, the anticoagulant effect is enhanced, 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 a mandatory systematic study of the content of prothrombin and other coagulation factors in the blood. Systematically conduct general urinalysis for early detection of hematuria.
In some patients, there is an orange staining of the palms and pink urine, which is associated with the metabolism of phenindione.
Pregnancy and lactation
Contraindicated in pregnancy. Avoid use in the first days after childbirth.
Phenindione should not be used during lactation (breastfeeding).
Phenindione should be canceled 2 days before the start and not used during menstruation.
For impaired renal function
The drug should be used with caution in renal failure.
For impaired liver function
The drug should be used with caution in hepatic insufficiency.
Use in the elderly
The drug should be used with caution in elderly patients.
A drug Phenylin- 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. Fenindione blocks K-vitamin reductase, disrupts the formation in the liver of the active form of vitamin K, which is necessary for the synthesis of prothrombin and other blood coagulation factors (VII, IX and X). Causes hypoprothrombinemia.
Reduces plasma tolerance to heparin, blood lipids 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 - 1 - 4 days after discontinuation of the drug. Pharmacokinetics
.
After oral administration, it is rapidly and almost completely absorbed. Communication with proteins is fragile. Passes through histohematic barriers (including placental), accumulates in tissues. Metabolized in the liver with the participation of cytochrome P-450. Excreted by the kidneys unchanged and as metabolites. Can accumulate.
Indications for use
A drug Phenylin 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 thrombosis in the postoperative period; mechanical prostheses of heart valves (permanent reception).Mode of application
Phenylin appoint adults and adolescents (over 14 years of age with a body weight of at least 45 kg; rarely prescribed) inside after meals.The optimal dose for 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 dose selection is individual.
Adults are prescribed on the first day of treatment at a daily dose of 120 - 180 mg (4 - 6 tablets) in 3 - 4 doses, on the second day - at a daily dose of 90 - 150 mg (3 - 5 tablets), then - 30 -
60 mg (1 - 2 tablets) in 1 - 2 doses, depending on the content of prothrombin in the blood.
Adolescents over 14 years of age (body weight not less than 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 content of prothrombin in the blood.
A 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 the level of 40-60%. If the level of prothrombin is less than 40-50%, the drug should be immediately discontinued.
For the prevention of thromboembolic complications appoint 30 mg (1 tablet) 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 prolonged use - micro- and macrohematuria, bleeding from the oral cavity and nasopharynx, gastrointestinal bleeding, hemorrhage into the muscles. On the part of the blood system: depression of bone marrow hematopoiesis (agranulocytosis, leukopenia, leukemoid reactions). From the digestive system: nausea, diarrhea, toxic hepatitis. From the side of the cardiovascular system: myocarditis. Allergic reactions: skin rash (erythematous, macular, papular), exfoliative dermatitis, eosinophilia, hyperthermia. From the urinary system: impaired renal function, urine staining in pink. Other: headache, orange staining of the palms.Contraindications
Contraindications to the use of the drug Phenylin are: increased individual sensitivity to the components of the drug, hemophilia, severe hepatic 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 III trimester), breastfeeding period, children's age.Pregnancy
A drug Phenylin contraindicated in pregnancy (especially in the 1st trimester and the second half of the 3rd trimester). The drug should not be used in the first days after childbirth. If necessary, use during lactation, breastfeeding should be discontinued.Interaction with other drugs
The action of the drug Phenylin enhance thrombolytic, antiplatelet agents, anticoagulants, adrenocorticotropic hormone, anabolics, azathioprine, allopurine, amiodarone, narcotic analgesics, androgens, antibiotics, tricyclic antidepressants, urine oxidizing agents, glucocorticosteroids, diazoxide, disopyramide, nalidixic acid, isoniazid, clofibrate, metronidazole , paracetamol, reserpine, vitamin E, butadione, sulfonamides, disufiram, quinidine, cyclophosphamide, thyroid hormones, cimetidine and other inhibitors of microsomal oxidation.The effect of the drug is weakened by vitamin K, propranolol, alkalizing urine, antacids, cholestyramine, phenazone, haloperidol, diuretics, carbamazepine, barbiturates, oral contraceptives, rifampicin.
Overdose
Overdose symptoms Fenilina: hemorrhagic syndrome (gastrointestinal, uterine, nasal bleeding, hematuria, hemorrhages in the skin, muscles, parenchymal organs). Treatment: drug withdrawal; intake of vitamin K inside (5 - 10 mg). With the development of serious bleeding, vitamin K is prescribed intravenously slowly (1 mg / min) in a total dose of 10-50 mg (normalizes increased prothrombin time for 6 hours). In case of massive bleeding or in patients with hepatic insufficiency, fresh frozen plasma is simultaneously prescribed. It is possible to use aminocaproic acid, vitamins C and P.Storage conditions
To store in the place protected from light at a temperature from 8 °C to 25 °C. Keep out of the reach of children.Shelf life - 3 years.
Release form
Phenylin - 30 mg tablets.No. 20 in a blister in a box.
Compound:
1 tablet Phenylin 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
The drug is prescribed with caution Phenylin in old age (increased risk of bleeding, especially intracranial), with hepatic and / or renal failure, increased vascular permeability, pericarditis, in the postpartum period, with gynecological diseases.In acute thrombosis, it is prescribed together with heparin.
During the course of treatment with the drug, systematic monitoring of the prothrombin ratio (normal values - 2.0 - 4.0), regular extended coagulation blood tests (coagulogram, thromboelastogram, platelet count), urinalysis for early detection of hematuria are necessary.
To control anticoagulant activity, the indicator of prothrombin time is used: reliable prevention of venous thrombosis is achieved with an increase in prothrombin time by 2 times, arterial time by 3-4 times (normal - 11-14 sec).
Do not prescribe the drug during menstruation (stop taking 2 days before it starts) and in the first days after childbirth.
The coloration of urine pink and 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. When staining the palms and changing the color of urine, it is recommended to replace the drug with another anticoagulant, with the exception of omefin.
Influence on the ability to drive vehicles and mechanisms. During the period of treatment, one should refrain from driving vehicles and engaging in potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions.
Main settings
| Name: | FENILIN |
| ATX code: | B01AA02 - |
Anticoagulant therapy in the prevention of systemic embolization in patients with rheumatic heart disease and atrial fibrillation. Prevention after prosthetic heart valves. 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; lactation; children's age up to 14 years; concomitant use with drugs that increase the risk of bleeding. Phenindione should not be administered to patients with severe renal or hepatic insufficiency, bacterial endocarditis, uncontrolled hypertension, actual or potential hemorrhagic conditions, as well as patients with hereditary galactose intolerance, lactase deficiency or malabsorption of glucose-galactase.
Application Precautions
Most adverse events associated with phenindione are the result of allergic reactions or an anticoagulant effect, so it is important that the need for therapy be reviewed by the 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 consult a doctor if any signs of adverse events are observed.
Conditions that may increase the effect of phenindione, requiring a reduction in dosage, include weight loss, advanced age, acute illness, impaired renal function, reduced dietary intake of vitamin K, taking certain groups of drugs (see section "Interaction").
Conditions in which the effect of phenindione may decrease, which may require an increase in dosage, include weight gain, diarrhea and vomiting, increased intake of vitamin K, fats or oils, taking certain drugs (see section "Interaction").
During therapy with phenindione using the standard dosing regimen, INR should be determined daily or every other day in the first days of treatment. Once the INR has stabilized within the target range, the INR can be determined at longer intervals. INR should be monitored more frequently in patients at increased risk, for example, in patients with severe hypertension, hepatic or renal insufficiency, and in patients for whom compliance with the dosing regimen may be difficult.
Thrombophilia. Patients with a deficiency of protein C or protein S are at risk, it is desirable 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 used with caution in patients at risk of serious bleeding (eg, concomitant use of non-steroidal anti-inflammatory drugs, ischemic stroke, bacterial endocarditis, history of gastrointestinal bleeding). Risk factors for bleeding include high anticoagulation intensity (INR > 4.0), age ≥ 65, highly variable INR, history of gastrointestinal bleeding, uncontrolled hypertension, cerebrovascular disease, heart 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 often, carefully adjust the dose of the drug until the desired INR is obtained, and minimize the duration of therapy. Patients should be instructed on measures to minimize the risk of bleeding and the need to immediately report signs and symptoms of bleeding to the doctor. Any concomitant antiplatelet drugs should be used with caution due to an increased risk of bleeding.
Bleeding. Bleeding may indicate an overdose of phenindione (see section "Overdose"). In case of unexpected bleeding, monitoring of INR is necessary, and the episode of bleeding during anticoagulant therapy should be fully studied and not automatically considered as a manifestation of overdose.
Ischemic attack. Anticoagulant therapy; following an ischemic stroke, increases the risk of secondary cerebral hemorrhage with a heart attack. 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 ischemic stroke, depending on the size of the infarct and blood pressure. In patients with major embolic strokes or uncontrolled hypertension, treatment should be stopped within 14 days.
Surgery. In surgical interventions without the risk of severe bleeding, surgery can be performed with INR
The introduction of vitamin K can lead to the development of resistance in the patient to the action of phenindione within a few days. Therefore, when bleeding in patients with prosthetic heart valves, the introduction of fresh frozen plasma is necessary.
Dentistry. Phenindione may be continued until routine dental surgery, such as 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 informed about how to recognize bleeding and what to do in case of bleeding.
Diseases of the thyroid gland. Patients with hyper- or hypothyroidism should be carefully monitored, especially at the start of anticoagulation therapy.
Dose adjustment of phenindione may be required in case 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 can be significantly affected by genetic variability, especially in relation to VKORC1 (vitamin K reductase). If a patient has family associations with this polymorphism, additional monitoring is necessary for such patients.
Interaction with otherschemical medicines
During therapy with phenindione, careful monitoring of all patients taking concomitant therapy is necessary. Any new concomitant therapy should be consulted for specific guidance on dose adjustments of phenindione. The need to expand coagulation monitoring should be considered in any new regimen if there is any doubt about the degree of interaction.
.Preparationsthat are contraindicated in therapyphenindione
The simultaneous use of drugs used in the treatment or prevention of thrombosis, or other drugs with negative consequences for 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 withopportunity to 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, clotting, or platelet action.
Low doses of aspirin with phenindione may be therapeutic in some patients but increase the risk of gastrointestinal bleeding.
Drugs that interact clinically withphenindione
The action of phenindione is potentiated by ACTH, allopurinol, amitriptyline / nortriptyline, cimetidine, dextropo-poxifene, glucagon, hepatotoxic drugs, phenformin, thyroid compounds, tolbutamide, disulfiram, amiodarone, propafenone, anabolic steroids, corticosteroids, oral contraceptives, zafirlukast.
The action of phenindione is reduced by barbiturates, carbamazepine, griseofulvin, 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.
An increase in INR has been reported in patients taking glucosamine or other anticoagulants (eg warfarin), so this combination is not recommended. Interaction with herbal products
Many herbal products theoretically have an effect on the action of phenindione. Patients should avoid taking any herbal medicines or nutritional supplements and should tell their doctor immediately if they are taking any herbal preparations, as this will require more frequent monitoring.
Interactions with food and nutritional supplements
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 regular cranberry juice. Some foods such as liver, broccoli, Brussels sprouts, and green leafy vegetables are high in vitamin K. Abrupt dietary changes can potentially affect anticoagulation control. Patients should be informed (INAUDIBLE) of medical advice before embarking on any major dietary changes. Many other dietary supplements have the theoretical effect of (INAUDIBLE) phenindione, but most of these interactions have not been proven. Patients should avoid taking any dietary supplements while taking phenindione, or consult their doctor if they are taking any dietary supplements.
Features of the use of medicinal mediayou 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 the period pregnancy and lactation
Oral anticoagulant therapy is contraindicated during pregnancy due to possible teratogenic effects and the risk of fetal bleeding. It is expected 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 completely safe and patient advice should be obtained from a specialist who has management skills. 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, infants from mothers receiving phenindione should not be breastfed.
Influence on the ability to drive vehicles and rawork with complex machines
Phenindione has no or negligible effect on the ability to drive or use machines.
Dosage and administration
I set the dose there is a doctor individually, taking into account h sensitivity to the drug, the nature of the disease levaniya, state indicators with blood coagulation systems and concomitant treatment.
Assign inside after eating. 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 of the state of the coagulation system of the body, such as prothrombin time and international normalized ratio (INR). It should be borne in mind that concomitant heparin therapy affects the results of INR, so the appointment of heparin should be canceled at least 6 hours before the determination of INR. Control tests of the state of the coagulation system of the body 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 occur 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 in any internal organ.
Treatment: The benefit of gastric decontamination is uncertain. In a patient within one hour of taking more than 0.25 mg/kg or more, 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 therapy with phenindione, INR monitoring is required for at least 48 hours after overdose (inaudible)
bleeding, but the prothrombin time is dangerous (MHC\u003e 6.0), you should immediately consult a doctor for rehabilitation measures.
For patients not on long-term therapy with phenindione, 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 siderespiratorysystems: 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 sideurinarysystems: frequency unknown - hematuria; kidney damage with tubular necrosis; albuminuria.
Others: frequency unknown - fever.
Lab Tests: the frequency is unknown - a decrease in hematocrit, a decrease in hemoglobin. Phenindione metabolites often impart a pink or orange color to the urine. This effect can be distinguished from the discoloration caused by hemoglobin by adding a few drops of dilute acetic acid to the urine. If the discoloration is due to phenindione, the discoloration will disappear immediately.
What do they say about such a drug as "Phenylin"? Feedback from doctors and patients will be discussed at the very end of the article. We will also tell you about the purposes for which this remedy is prescribed, how to take it correctly, whether it has side effects, analogues and contraindications.
Composition and form
In what form is the drug "Fenilin" produced? Instructions for use informs 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 components.
Pharmacodynamics
What pharmacological features does the drug "Fenilin" have? Instructions for use states that this drug has a direct effect on It is an action.
Taking the medication contributes to the occurrence of hypoprothrombinemia, which is caused by a violation of the formation of prothrombin in the liver. Also, this agent significantly reduces the formation of factors 7, 9 and 10. At the same time, 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 of experts say that this medication is characterized by complete and fairly rapid absorption. Its active ingredient penetrates the histo-hematic barriers and accumulates in the tissues.
The drug is metabolized in the liver and excreted by the kidneys (in the form of metabolites and unchanged).
Indications for use
What is the purpose of prescribing Phenylin tablets? Reviews of experts report that this drug is used for both treatment and prevention. The main indications for admission 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 thrombus formation after surgery.
Contraindications for use
Under what conditions of the patient is it forbidden to take the drug "Fenilin"? Instructions for use informs about the following contraindications:
- disorders in the work of the kidneys and liver;
- initial level of prothrombin up to 70%;
- increased vascular permeability;
- and other diseases associated with a decrease in blood clotting;
- peptic ulcers of the gastrointestinal tract;
- malignant neoplasms;
- pericarditis.
It cannot be said that the drug in question is not recommended for use at the very beginning of pregnancy, within a few days after childbirth and during menstruation.
The drug "Fenilin": instructions for use
The medication in question is used only for oral administration. Its therapeutic regimen has certain features, in this regard, this medicine should be used only as prescribed by the 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 later to 0.02-0.05 g. After that, 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.
For the prevention of thromboembolic complications, it is necessary to take 0.03 g of the drug per day, dividing this dose into two times.
Therapy of acute thrombosis requires additional administration of heparin. This requires strict control by the doctor, as well as a mandatory systematic study of the amount of prothrombin in the blood and other factors of its coagulability.
Treatment with the drug "Fenilin", whose analogues we will definitely list below, is stopped gradually.
Side effects
Does the drug "Fenilin" cause side effects? The method of application and dosage of this medicine must be strictly observed. 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 the reviews of doctors and patients, in rare cases, headaches, fever, skin changes, and problems with hematopoiesis are observed.
Signs of an overdose
In case of an overdose, patients may experience an exacerbation of symptoms that are related to side effects. As a treatment for such conditions, the mandatory withdrawal of the drug is necessary, as well as the immediate intramuscular administration of Vikasol, the appointment of rutin, or vitamin P, calcium chloride, ascorbic acid, and general symptomatic therapy.
Drug interaction of the drug "Fenilin"
From what this remedy is prescribed, we described above. Let's move on to more information.
When the drug in question is combined with Heparin, salicylates, Cimetidine and sulfonamides, their anticoagulant effect may be enhanced. At the same time, anabolics, Allopurinol, Azathioprine, narcotic analgesics, Amiodarone, tricyclic antidepressants, antibiotics, glucocorticosteroids, androgens, Diazoxide, Disopyramide, Isoniazid, " Butadion, Metronidazole, Clofibrate, Alpha Tocopherol, Reserpine, Quinidine, Paracetamol, Disulfiram, Cyclophosphamide and thyroid hormones.
Vitamin K, Propranolol, ascorbic acid, urine alkalinizers, Rifampicin, antacids, Phenazone, Haloperidol, barbiturates, oral contraceptives, diuretics, Meprotan, Carbamazepine and " Colestyramine".
With special care, 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 with pericarditis.
Treatment with "Fenilin" 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 carried out for the purpose of early detection of hematuria.
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 "Fenilin": analogues and cost
The main analogues of the agent under consideration are such drugs as Varfapex, Marevan, Neodicumarin, etc.
You can buy the drug "Fenilin" in the amount of 20 tablets for 120-140 rubles.
