Anisindione Side Effects, Overdose and Pregnancy Information

Anisindione is a type of drug known as an oral anticoagulant(blood thinner). Anisindione is used to stop blood clots forming within the blood vessels, reducing the risk of small-cell carcinoma of the lung, repeated heart attack or stroke and transient ischemic attack (TIA). Anisindione takes about three days to produce its full anticoagulant effect because, while it prevents the production of new vitamin-k-dependent clotting factors, it takes about this long for vitamin-k-dependent clotting factors that have already been produced to be used up. For this reason, when treating blood clots such as deep vein thrombosis (DVT) or pulmonary embolism, a fast-acting injectable anticoagulant is often used instead.

Anisindione Side Effects

Common side effects of Anisindione include rash, blurred vision, bleeding and headache. Rare side effects of Anisindione may include diarrhea, nausea and vomiting, hepatitis, sore throat, red or orange urine, yellowing of the skin and eyes (jaundice), and liver disorders.

Anisindione Warning

Take extra care when participating in physical activities while taking Anisindione, as even minor injury may result in bleeding/bruising.

Because Anisindione prevents blood clotting, too much can increase your risk of bleeding. On the other hand, too little will not be effective at preventing clotting. It is therefore important that you have regular blood tests to monitor your blood clotting ability (INR) so that your dose can be altered if necessary. Consult your physician about when your INR will need checking.

As Anisindione works by inhibiting the action of vitamin K, changes to your dietary intake of vitamin K can alter the effect of your Anisindione. For this reason, avoid making sudden major changes to your diet, particularly your consumption of green tea, salad and green vegetables (eg broccoli, brussel sprouts, or spinach), which contain large amounts of vitamin K. Large amounts of green vegetables (more than 500g daily) can reduce the effect of Anisindione and should be avoided. Changes to your consumption of fats and oils can also alter the effect of Anisindione, as vitamin K is a fat soluble vitamin.

The effects of Anisindione can also be altered by other foods, for example soy products can reduce the effect of Anisindione, and avocados and large amounts of ice cream (over a litre a day) have also been reported to have this effect. Cranberry juice should be avoided, as should large amounts of alcohol, as these may increase the effect of Anisindione. Anisindione's effect can also be altered by sudden increases or decreases in your body weight. For these reasons you should avoid making sudden major changes to your diet during treatment with Anisindione. For more information talk to your pharmacist.

Consult your physician right away if you experience any bruising, bleeding, dark stools, blood in the urine, vomiting, diarrhea, fever or acute illness while taking Anisindione, so that your INR can be checked.

You should be given an anticoagulant treatment booklet when you start treatment with this medicine. This will contain details of your Anisindione dose and INR and will also give advice on your anticoagulant treatment.

Inform any health care professional including your dentist, that you are taking Anisindione before surgery/dental work.

Anisindione Caution

Small dosage may be needed in the following group:

Seniors.
People with decreased kidney function.
People with decreased liver function.
People who have had recent surgery, bleeding or major injury.

Anisindione should not be given to the following group :

People who are more prone to bleeding than normal, eg due to the blood clotting disorder haemophilia.
Active bleeding.
Severe kidney disease.
Severe liver disease.
Bacterial infection of the heart valves and the lining surrounding the heart (bacterial endocarditis).
Uncontrolled high blood pressure (hypertension).
Peptic Ulcer.
Pregnant women.
Anisindione should not be used if you are allergic to one or any of its ingredients.

Anisindione and Pregnancy

Anisindione should not be used during pregnancy, especially during the first three months, as it passes into fetal circulation and causes bleeding, brain and other abnormalities and even stillbirth. Pregnant women are often given heparin instead as it does not pass into fetal blood circulation.

Anisindione passes into breast milk and nursing mothers should switch to bottle-feed while taking Anisindione.

Anisindione Interaction

The following drugs may enhance the effects of Anisindione (increased INR; Anisindione dose may need reducing):

allopurinol
amiodarone
antibiotic drugs
antifungal drugs
anabolic steroids
aspirin (may also irritate the stomach lining, which can result in bleeding from the stomach or intestine in people taking Anisindione)
certain chemotherapy regimens
cimetidine
danazol
dextropropoxyphene
diflunisal
dipyridamole
disulfiram
fibrate drugs
flutamide
glucagon (large doses)
glucosamine supplements
non-steroidal anti-inflammatory drugs NSAIDs, eg ibuprofen.
omeprazole
long-term regular use of Acetaminophen(paracetamol) (occasional doses should not affect Anisindione radically)
proguanil
propafenone
statins
sulfinpyrazone
tamoxifen
thyroxine
zafirlukast.

The following drugs may reduce the effect of Anisindione (decreased INR; Anisindione dose may need increasing):

aminoglutethimide
azathioprine
barbiturates
carbamazepine
certain chemotherapy regimens
colestyramine
griseofulvin
oestrogens
progestogens
raloxifene
rifampicin
sucralfate
the herb St John's Wort
vitamin K.

The following drugs may also alter the effect of Anisindione and the dose of Anisindione may need to be adjusted up or down.

corticosteroids
phenytoin
quinidine
ritonavir.

Anisindione may enhance the blood sugar lowering effect of antidiabetic tablets.
There may be an increased risk of bleeding if Anisindione is taken in combination with any of the following drugs:

antiplatelet or 'blood thinning' drugs such as low-dose aspirin.
heparin
low molecular weight heparins
SSRI antidepressants

Anisindione Overdose

Anisindione overdose symptoms may include bleeding (most common), blood in urine or stool, and bleeding gum. Seek medical attention right away.

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