← Search & browse all drugs
BLOOD AND BLOOD FORMING ORGANS › ANTITHROMBOTIC AGENTS › ANTITHROMBOTIC AGENTS › Vitamin K antagonists
ethyl biscoumacetate
B01AA08
Adult Dosing
- Initial dose: 600 to 900 mg on the first day, followed by 300 to 600 mg on the second day
- Maintenance dose: 100 to 400 mg daily, adjusted based on prothrombin time or INR
Pediatric Dosing
- Safety and efficacy not well established in pediatric patients; use is generally avoided
Indications
- Prophylaxis and treatment of venous thrombosis and its extension
- Prophylaxis and treatment of thromboembolic complications associated with atrial fibrillation or cardiac valve replacement
Mechanism of Action
- Coumarin derivative anticoagulant that acts as a vitamin K antagonist
- Inhibits vitamin K epoxide reductase, preventing the recycling of vitamin K and blocking the gamma-carboxylation of clotting factors II, VII, IX, and X, as well as proteins C and S
Contraindications
- Active bleeding or bleeding tendencies
- Recent or potential surgery of the central nervous system or eye
- Severe hepatic impairment
- Severe renal impairment
- Uncontrolled hypertension
- Known hypersensitivity to ethyl biscoumacetate or other coumarin derivatives
- Pregnancy
Adverse Reactions
- Major and minor hemorrhage
- Nausea, vomiting, diarrhea, abdominal pain
- Alopecia
- Hypersensitivity skin reactions and rash
- Rarely, coumarin necrosis or purple toe syndrome
Drug Interactions
- Potentiated anticoagulant effect with CYP2C9 inhibitors (e.g., amiodarone, fluconazole, metronidazole)
- Diminished anticoagulant effect with CYP2C9 inducers (e.g., rifampin, barbiturates, carbamazepine)
- Increased bleeding risk with antiplatelet agents (e.g., aspirin, clopidogrel) and NSAIDs
- Displacement from plasma protein binding sites by agents such as phenylbutazone or sulfonamides
Curated Content: Needs Vetting Before Put to Clinical Use