Acitrom 0.5Mg Strip Of 10 Tablets

• Treatment and prevention of diseases where the blood vessels are obstructed (thromboembolic diseases), such as Deep vein thrombosis (mainly affects legs) and other disorders related to the heart, lungs and brain due to blood clot formation.
• As an adjuvant in the treatment of obstruction of blood flow through the heart due to blood clots (coronary occlusion).

• If you are allergic to Acenocoumarol or any ingredient of this medicine.
• If you are at a risk of bleeding due to blood disorders.
• If you have high blood pressure or accumulation of fluid around the heart.
• If you have a recent history of stroke due to bleeding in the brain or brain haemorrhages.
• If you have stomach ulcers or intestinal bleeding, urinary tract infection or respiratory tract problem.
• If you recently had or about to have surgery, have a liver or kidney problem, pregnant or planning a baby.
• People who are difficult to co-operate such as alcoholics, with mental deterioration or psychiatric disorders.

• Bruising more easily than usual
• Bleeding from the gums or nose
• Heavier or prolonged menstrual bleeding
• Blood in the urine or stools
• Nausea or loss of appetite
• Hair loss with long-term use
• Rash
• Rarely, painful skin patches that darken, which need urgent assessment

Other General Warnings

• You are suffering from a liver problem as the liver is the main site of the formation of blood clotting factors, and it can be affected. You may get a liver disorder.
• You have kidney or heart problem; the dose will be decided depending upon the severity of your underlying conditions.
• You are suffering from a blood disorder like abnormal bleeding after injury; caution is required for such patients.
• You are an older person or giving it to a child, be cautious and more frequent monitoring of PT/INR is recommended.
• You are suffering from a rare condition where calcium builds up in blood vessels in the skin, as these medicines contain calcium.
• You have disorders due to which absorption from the gut is not proper.
• You have increased thyroid levels, infection or inflammation, cancer or tumour.
• If you experience bleeding problems, reach out to your doctor.

• Take Acitrom 0.5mg Tablet exactly as prescribed, in the dose stated at your most recent INR check.
• Swallow the tablet whole with water.
• Take it at the same time each day, usually in the evening so that dose changes after a daytime INR test can be applied the same day.
• Never change the dose yourself, and never take extra to compensate for a missed dose.
• Attend every INR appointment and keep your anticoagulant record book up to date.
• Carry an anticoagulant alert card at all times.

• Store Acitrom 0.5mg Tablet in a cool, dry place away from direct sunlight and moisture.
• Keep the tablets in their original strip, and take care not to confuse different strengths, as tablets look similar.
• Keep out of the sight and reach of children and pets; this medicine is extremely dangerous for a child.
• Do not use after the expiry date on the pack, and dispose of unused or expired tablets safely.

• Attend every INR blood test; the dose of this medicine is set entirely by the result.
• Keep your intake of green leafy vegetables steady each week rather than avoiding them altogether.
• Avoid sudden diet changes, crash diets and week-long swings in how much salad or greens you eat.
• Avoid cranberry juice, large amounts of mango, and grapefruit juice, which can raise your INR.
• Tell any doctor prescribing an antibiotic that you take this medicine, and ask when to recheck your INR.
• Use paracetamol rather than ibuprofen or aspirin for pain, and tell your doctor if you need it regularly.
• Use a soft toothbrush and an electric shaver, and take care with knives and sharp tools.
• Seek urgent help for black stools, blood in urine or vomit, a severe headache, or bleeding that will not stop.
• Get medical assessment after any fall or blow to the head, even if you feel completely well.
• Avoid binge drinking, which can push your INR up sharply.
• Carry your anticoagulant alert card and record book at all times.
• Do not use ginkgo, high-dose garlic, ginger, turmeric or fish oil supplements without medical advice.
• Tell your doctor immediately if you are pregnant or planning pregnancy, as this medicine must be changed.

Overdose

Missed a Dose

• Acitrom 0.5mg Tablet contains acenocoumarol, which interferes with the way the body uses vitamin K. The liver needs vitamin K to finish making four of the proteins that drive blood clotting, known as factors II, VII, IX and X.
• Each time vitamin K is used in this process it is chemically altered and must be recycled back to its usable form by an enzyme called vitamin K epoxide reductase. Acenocoumarol blocks that enzyme, so the supply of usable vitamin K falls and the liver cannot complete production of these clotting factors.
• With fewer functioning clotting factors in circulation, the blood clots more slowly and existing clots are less likely to grow or new ones to form. Because clotting factors already in the bloodstream must be used up first, the full effect appears only after three to five days, and for the same reason the effect persists for several days after stopping.

Interactions with other medicines

• Acenocoumarol interacts with a very large number of medicines, foods and supplements, and even small changes can move the INR into a dangerous range in either direction.
• Tell every doctor, dentist and pharmacist that you take this medicine before anything new is started or stopped, and ask when your INR should be rechecked.
• Life-threatening: Antibiotics and antifungals, particularly ciprofloxacin, metronidazole, co-trimoxazole, erythromycin, clarithromycin and fluconazole, can raise the INR sharply within days and cause major bleeding. An INR check is needed whenever one is prescribed.
• Life-threatening: Aspirin and anti-inflammatory painkillers such as ibuprofen, diclofenac and naproxen impair platelets and damage the stomach lining while the blood is already thinned, producing a high risk of severe gastrointestinal bleeding.
• Life-threatening: Amiodarone substantially increases the effect of acenocoumarol, and the raised INR can persist for weeks after amiodarone is stopped. The anticoagulant dose usually needs a large reduction.
• Severe: Other anticoagulants and antiplatelet medicines, including clopidogrel and heparin, greatly increase bleeding risk when combined and are only used together under specialist supervision.
• Severe: Carbamazepine, rifampicin, phenobarbital, phenytoin and St John's wort speed up the breakdown of acenocoumarol, dropping the INR and leaving you unprotected against a clot or stroke.
• Severe: Regular high-dose paracetamol raises the INR and is a frequently overlooked cause of unexpected over-anticoagulation. Occasional single doses are usually acceptable.
• Moderate: Thyroid hormones such as levothyroxine increase the effect of acenocoumarol, so the INR should be rechecked when a thyroid dose changes.
• Moderate: Statins, omeprazole, allopurinol and some antidepressants can modestly raise the INR.
• Moderate: Corticosteroids, oral contraceptives and azathioprine may reduce the anticoagulant effect.

Interactions with food items

• Vitamin K is the central dietary issue, and consistency matters far more than avoidance. Spinach, methi, mustard greens, cabbage, broccoli, coriander, mint and green tea are all rich in vitamin K, which works against this medicine. Eat a steady, moderate amount each week so your dose can be matched to it.
• Avoid sudden changes. Starting a green juice regimen, a crash diet, or a week of heavy salad eating can drop the INR and leave you at risk of a clot; abruptly cutting all greens can push it dangerously high.
• Cranberry juice, mango and grapefruit juice have all been reported to raise the INR and increase bleeding risk. Avoid large or regular quantities.
• Avoid binge drinking, which can raise the INR sharply. If your doctor allows alcohol at all, keep it small and consistent.
• Be careful with supplements. Ginkgo biloba, high-dose garlic, ginger, ginseng, turmeric, fish oil, vitamin E and dong quai all affect bleeding or the INR. Culinary amounts in cooking are not a problem; concentrated capsules are.
• Tell the anticoagulation clinic if illness, vomiting or diarrhoea stops you eating normally for more than a day or two, as this alone can move the INR.