Acenocoumarol

Brand: Acitrom / Sintrom / Nicoumalone

Anticoagulant Vitamin K antagonist

Chemistry

Molecular Formula	C19H15NO6
PubChem	CID: 656548 Open in PubChem

Structure

Half-life	10 hours
Tmax	1 h
Bioavailability	98 % (approx)
Protein Binding	98 %
Volume of Distribution	0.2 L/kg (approx)
Clearance Route	hepatic
Active Metabolites	no
Notes	Shorter half-life than warfarin; INR unstable in non-compliant patients; rapid offset.

Severity: Severe

Adverse Effects:
Bleeding (GI/intracranial), skin necrosis (rare in protein C/S deficiency), INR variability, teratogenicity

Contraindications:
Pregnancy, active bleeding, severe hepatic impairment, uncontrolled hypertension

Precautions:
Requires frequent INR monitoring; avoid sudden dietary vitamin K changes; more sensitive to missed doses due to shorter half-life