Generic Name

Anisindione

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Classification

FDA Approved Indications

• Prevention and treatment of thromboembolic disorders, such as deep vein thrombosis (DVT), pulmonary embolism (PE), and atrial fibrillation

Mechanism of Action

Anisindione inhibits the synthesis of vitamin K-dependent clotting factors II, VII, IX, and X, leading to anticoagulation.

Dosage and Administration

Adult: Typically, 2–4 mg orally once daily, adjusted based on INR monitoring.

Pediatric: Use is limited; dosing not well established.

Geriatric: Begin at lower doses due to increased bleeding risk; monitor closely.

Renal Impairment: Use with caution; dose adjustment may be necessary.

Hepatic Impairment: Use with caution; impaired synthesis of clotting factors may alter response.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed, crosses placental barrier.

Metabolism: Hepatic metabolism, primarily via conjugation.

Excretion: Metabolites excreted primarily in urine.

Half Life: Approximately 25–60 hours, allowing once-daily dosing.

Contraindications

• Active bleeding
• Hemorrhagic disorders
• Known hypersensitivity

Precautions

• Pregnancy risk due to teratogenic potential (category X)
• Use with caution in patients with liver disease, hypertension, or recent surgery

Adverse Reactions - Common

• Bleeding (Common)

Adverse Reactions - Serious

• Hemorrhage leading to hypovolemic shock or death (Serious)
• Hepatic toxicity (Rare)

Drug-Drug Interactions

• Other anticoagulants, antiplatelet agents, NSAIDs, certain antibiotics

Drug-Food Interactions

• Foods high in vitamin K (green leafy vegetables) may reduce efficacy

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Take medication exactly as prescribed.
• Report signs of bleeding (e.g., bruising, hematuria, melena).
• Avoid sudden dietary changes in vitamin K intake.
• Inform about potential drug and food interactions.

Special Considerations

Black Box Warnings:

• Risk of severe or fatal bleeding.

Genetic Factors: Genetic variations may affect metabolism and response.

Lab Test Interference: May interfere with certain coagulation tests; INR is the standard monitoring parameter.

Overdose Management

Signs/Symptoms: Excessive bleeding, hematuria, hematomas.

Treatment: Discontinue drug; administer fresh frozen plasma, vitamin K, or prothrombin complex concentrates as needed.

Storage and Handling

Storage: Store at room temperature, protected from moisture and light.

Stability: Stable for prescribed period when stored properly.