indication

For the prophylaxis and treatment of venous thrombosis and its extension, the treatment of atrial fibrillation with embolization, the prophylaxis and treatment of pulmonary embolism, and as an adjunct in the treatment of coronary occlusion.

pharmacology

Anisindione is a synthetic anticoagulant and an indanedione derivative. It is prescribed only if you cannot take coumarin-type anticoagulants such as coumadin as anisindione is a powerful drug with serious potential side effects. Anticoagulants decrease the clotting ability of the blood and therefore help to prevent harmful clots from forming in the blood vessels. These medicines are sometimes called blood thinners, although they do not actually thin the blood. They also will not dissolve clots that already have formed, but they may prevent the clots from becoming larger and causing more serious problems.

mechanism of action

Like phenindione, to which it is related chemically, anisindione exercises its therapeutic action by reducing the prothrombin activity of the blood. Anisindione prevents the formation of active procoagulation factors II, VII, IX, and X, as well as the anticoagulant proteins C and S, in the liver by inhibiting the vitamin K–mediated gamma-carboxylation of precursor proteins. Anisindione has no direct thrombolytic effect and does not reverse ischemic tissue damage, although it may limit extension of existing thrombi and prevent secondary thromboembolic complications.

toxicity

An overdose is likely to cause abnormal bleeding, for which the symptoms include: bleeding from gums or nose, blood in urine or stools, excessive bleeding from minor cuts, patches of discoloration or bruises on the skin.

absorption

Accumulation does not occur with repeated dosing.

half life

Not Known

drug interactions

Acetaminophen: Acetaminophen increases the anticoagulant effect of anisindione. Monitor for changes in the therapeutic and adverse effects of anisindione if acetaminophen is initiated, discontinued or dose changed.

Acetylsalicylic acid: Acetylsalicylic acid increases effect of the anticoagulant, anisindione.

Allopurinol: Allopurinol may increase the anticoagulant effect of anisindione.

Aminoglutethimide: Aminoglutethimide may decrease the anticoagulant effect of anisindione.

Amiodarone: Amiodarone may increase the anticoagulant effect of anisindione.

Amprenavir: Amprenavir may increase the anticoagulant effect of anisindione by increasing its serum concentration.

Aprepitant: Aprepitant may decrease the anticoagulant effect of anisindione by decreasing its serum concentration.

Atazanavir: The protease inhibitor, atazanavir, may increase the anticoagulant effect of anisindione.

Azathioprine: Azathioprine may decrease the anticoagulant effect of anisindione.

Azithromycin: Azithromycin may increase the anticoagulant effect of anisindione by increasing its serum concentration.

Betamethasone: The corticosteroid, betamethasone, alters the anticoagulant effect of anisindione.

Bosentan: Bosentan may decrease the anticoagulant effect of anisindione by increasing its metabolism.

Capecitabine: Capecitabine may increase the anticoagulant effect of anisindione by increasing its serum concentration.

Carbamazepine: Carbamazepine may decrease the anticoagulant effect of anisindione by decreasing its serum concentration.

Cefotetan: The cephalosporin, cefotetan, may increase the anticoagulant effect of anisindione.

Cefoxitin: The cephalosporin, cefoxitin, may increase the anticoagulant effect of anisindione.

Ceftriaxone: The cephalosporin, ceftriaxone, may increase the anticoagulant effect of anisindione.

Celecoxib: Celecoxib may increase the anticoagulant effect of anisindione.

Cholestyramine: The bile acid sequestrant, cholestyramine, may decrease the anticoagulant effect of anisindione by decreasing its absorption.

Cimetidine: Cimetidine may increase the anticoagulant effect of anisindione.

Ciprofloxacin: The quinolone antibiotic, ciprofloxacin, may increase the anticoagulant effect of anisindione.

Cisapride: Cisapride may increase the anticoagulant effect of anisindione.

Citalopram: The SSRI, citalopram, increases the effect of anticoagulant, anisindione.

Clarithromycin: The macrolide, clarithromycin, may increase the anticoagulant effect of anisindione.

Clofibrate: The fibrate increases the anticoagulant effect

Colestipol: The bile acid sequestrant, colestipol, may decrease the anticoagulant effect of anisindione by decreasing its absorption.

Cyclophosphamide: The antineoplastic agent, cyclophosphamide may alter the anticoagulant effect of anisindione.

Danazol: The androgen, danazol, may increase the anticoagulant effect of anisindione.

Demeclocycline: The tetracycline, demeclocycline, may increase the anticoagulant effect of anisindione.

Dexamethasone: The corticosteroid, dexamethasone, alters the anticoagulant effect of anisindione.

Dextrothyroxine: The thyroid hormone, dextrothyroxine, increase the anticoagulant effect of anisindione.

Diclofenac: The NSAID, diclofenac, may increase the anticoagulant effect of anisindione.

Dicloxacillin: Dicloxacillin may decrease the anticoagulant effect of anisindione.

Diflunisal: The NSAID, diflunisal, may increase the anticoagulant effect of anisindione.

Disulfiram: Disulfiram may increase the anticoagulant effect of anisindione.

Doxycycline: The tetracycline, doxycycline, may increase the anticoagulant effect of anisindione.

Erythromycin: The macrolide, erythromycin, may increase the anticoagulant effect of anisindione.

Ethchlorvynol: Ethchlorvynol may decrease the anticoagulant effect of anisindione.

Ethinyl Estradiol: Increased thrombotic risk due to estrogen

Etodolac: The NSAID, etodolac, may increase the anticoagulant effect of anisindione.

Etoricoxib: Etoricoxib may increase the anticoagulant effect of anisindione.

Fenofibrate: Fenofibrate may increase the anticoagulant effect of anisindione.

Fenoprofen: The NSAID, fenoprofen, may increase the anticoagulant effect of anisindione.

Fluconazole: Fluconazole may increase the serum concentration of anisindione by decreasing its metabolism.

Fludrocortisone: The corticosteroid, fludrocortisone, alters the anticoagulant effect of anisindione.

Fluorouracil: The antineoplasic agent, fluorouracil, may increase the anticoagulant effect of anisindione.

Fluoxetine: The SSRI, fluoxetine, increases the effect of anticoagulant, anisindione.

Fluoxymesterone: The androgen, fluoxymesterone, may increase the anticoagulant effect of anisindione.

Flurbiprofen: The NSAID, flurbiprofen, may increase the anticoagulant effect anisindione.

Fluvastatin: Fluvastatin may increase the anticoagulant effect of anisindione. Monitor for changes in the therapeutic and adverse effects of anisindione if fluvastatin if initiated, discontinued or dose changed.

Fluvoxamine: Fluvoxamine may increase the anticoagulant effect of anisindione by increasing its serum concentration.

Fosamprenavir: The protease inhibitor, fosamprenavir, may increase the anticoagulant effect of anisindione.

Fosphenytoin: Increased hydantoin levels and risk of bleeding

Gefitinib: Gefitinib may increase the anticoagulant effect of anisindione.

Gemcitabine: Gemcitabine may increase the anticoagulant effect of anisindione.

Gemfibrozil: Gemfibrozil may increase the anticoagulant effect of anisindione.

Glutethimide: Glutethimide may decrease the anticoagulant effect of anisindione.

Griseofulvin: Griseofulvin may decrease the anticoagulant effect of anisindione.

Hydrocortisone: The corticosteroid, hydrocortisone, alters the anticoagulant effect of anisindione.

Ibuprofen: The NSAID, ibuprofen, may increase the anticoagulant effect of anisindione.

Imatinib: Imatinib may increase the anticoagulant effect of anisindione.

Indinavir: The protease inhibitor, indinavir, may increase the anticoagulant effect of anisindione.

Indomethacin: The NSAID, indomethacin, may increase the anticoagulant effect of anisindione.

Isoniazid: Isoniazid may increase the anticoagulant effect of anisindione.

Itraconazole: Itraconazole may increase the anticoagulant effect of anisindione.

Ketoconazole: Ketoconazole may increase the anticoagulant effect of anisindione.

Ketoprofen: The NSAID, ketoprofen, may increase the anticoagulant effect of anisindione.

Ketorolac: The NSAID, ketorolac, may increase the anticoagulant effect of anisindione.

Leflunomide: Leflunomide may increase the anticoagulant effect of anisindione.

Levamisole: Levamisole may increase the anticoagulant effect of anisindione.

Levofloxacin: The quinolone antibiotic, levofloxacin, may increase the anticoagulant effect of anisindione.

Levothyroxine: The thyroid hormone, levothyroxine, increase the anticoagulant effect of anisindione.

Lovastatin: Lovastatin may increase the anticoagulant effect of anisindione. Monitor for changes in the therapeutic and adverse effects of anisindione if lovastatin if initiated, discontinued or dose changed.

Lumiracoxib: Lumiracoxib may increase the anticoagulant effect of anisindione.

Medroxyprogesterone: Medroxyprogesterone may increase the anticoagulant effect of anisindione.

Mefenamic acid: The NSAID, mefanamic acid, may increase the anticoagulant effect of anisindione.

Mefloquine: Mefloquine may increase the anticoagulant effect of anisindione.

Meloxicam: Meloxicam may increase the anticoagulant effect of anisindione.

Mercaptopurine: Mercaptopurine may decrease the anticoagulant effect of anisindione.

Methimazole: The antithyroid agent, methimazole, may decrease the anticoagulant effect of anisindione.

Metronidazole: Metronidazole may increase the anticoagulant effect of anisindione.

Miconazole: Miconazole may increase the serum concentration of anisindione by decreasing its metabolism.

Minocycline: The tetracycline, minocycline, may increase the anticoagulant effect of anisindione.

Mitotane: Mitotane may decrease the anticoagulant effect of anisindione.

Moxifloxacin: The quinolone antibiotic, moxifloxacin, may increase the anticoagulant effect of anisindione.

Nabumetone: The NSAID, nabumetone, may increase the anticoagulant effect anisindione.

Nalidixic Acid: The quinolone antibiotic, nalidixic acid, may increase the anticoagulant effect of anisindione.

Naproxen: The NSAID, naproxen, may increase the anticoagulant effect of anisindione.

Nelfinavir: The protease inhibitor, nelfinavir, may increase the anticoagulant effect of anisindione.

Nevirapine: Nevirapine may decrease the anticoagulant effect of anisindione.

Norfloxacin: The quinolone antibiotic, norfloxacin, may increase the anticoagulant effect of anisindione.

Ofloxacin: The quinolone antibiotic, ofloxacin, may increase the anticoagulant effect of anisindione.

Orlistat: Orlistat may increase the anticoagulant effect of anisindione.

Oxaprozin: The NSAID, oxaprozin, may increase the anticoagulant effect of anisinodione.

Oxyphenbutazone: The NSAID, oxyphenbutazone, may increase the anticoagulant effect of anisindione.

Paroxetine: The SSRI, paroxetine, increases the effect of the anticoagulant, anisindione.

Pentoxifylline: Pentoxifylline may increase the anticoagulant effect of anisindione.

Phenobarbital: The barbiturate, phenobarbital, decreases the anticoagulant effect of anisindione.

Phenylbutazone: The NSAID, phenylbutazone, may increase the anticoagulant effect of anisindione.

Phenytoin: Increased hydantoin levels and risk of bleeding

Piroxicam: The NSAID, piroxicam, may increase the anticoagulant effect of anisindione.

Prednisolone: The corticosteroid, prednisolone, alters the anticoagulant effect of anisindione.

Prednisone: The corticosteroid, prednisone, alters the anticoagulant effect of anisindione.

Primidone: The barbiturate, primidone, decreases the anticoagulant effect of anisindione.

Propafenone: Propafenone may increase the anticoagulant effect of anisindione.

Propoxyphene: Propoxyphene may increase the anticoagulant effect of anisindione.

Propylthiouracil: The anti-thyroid agent, propylthiouracil, may decrease the anticoagulant effect of anisindione.

Quinidine: Quinidine may increase the anticoagulant effect of anisindione.

Quinine: Quinine may increase the anticoagulant effect of anisindione.

Ranitidine: Ranitidine may increase the anticoagulant effect of anisindione. (Conflicting evidence)

Rifabutin: Rifabutin, may decrease the anticoagulant effect of anisindione.

Rifampin: Rifampin may decrease the anticoagulant effect of anisindione.

Telithromycin: Telithromycin may increase the anticoagulant effect of anisindione.

Tenoxicam: The NSAID, tenoxicam, may increase the anticoagulant effect of anisindione.

Testosterone: The androgen may increase the anticoagulant effect of anisindione.

Tetracycline: Tetracycline may increase the anticoagulant effect of anisindione.

Tigecycline: Tigecycline may increase the anticoagulant effect of anisindione.

Triamcinolone: The corticosteroid, triamcinolone, alters the anticoagulant effect of anisindione.