← Search & browse all drugs
BLOOD AND BLOOD FORMING ORGANS › ANTITHROMBOTIC AGENTS › ANTITHROMBOTIC AGENTS › Vitamin K antagonists
fluindione
B01AA12
Adult Dosing
- Initial dose: 20 mg daily adjusted according to INR
- Maintenance dose: 10 to 20 mg daily based on target INR (typically 2.0 to 3.0)
Pediatric Dosing
- Safety and efficacy not established in pediatric patients
Indications
- Prophylaxis and treatment of thromboembolic disorders
- Prevention of systemic embolism in atrial fibrillation, mechanical heart valves, and deep vein thrombosis
Mechanism of Action
- Vitamin K antagonist that inhibits the gamma-carboxylation of vitamin K-dependent coagulation factors II, VII, IX, and X, as well as endogenous protein C and protein S
Contraindications
- Hypersensitivity to fluindione or vitamin K antagonists
- Active bleeding or high bleeding risk conditions
- Severe hepatic impairment
- Pregnancy (teratogenic and causes fetal bleeding)
- Recent cerebral hemorrhage
- Co-administration with miconazole
Adverse Reactions
- Major and minor hemorrhages
- Hypersensitivity reactions including drug rash with eosinophilia and systemic symptoms (DRESS syndrome)
- Hepatitis and abnormal liver function tests
- Alopecia
- Nausea and gastrointestinal disturbances
- Calciphylaxis
Drug Interactions
- CYP2C9 inducers (e.g., rifampin, carbamazepine) decrease anticoagulant effect
- CYP2C9 inhibitors (e.g., fluconazole, amiodarone) increase anticoagulant effect and bleeding risk
- Pharmacodynamic interactions with antiplatelet agents (e.g., aspirin, clopidogrel) and NSAIDs significantly increase bleeding risk
- Displacement from plasma protein binding sites by drugs like phenylbutazone
- Alteration of vitamin K absorption or synthesis by broad-spectrum antibiotics
Curated Content: Needs Vetting Before Put to Clinical Use