Sinthrome

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Bleeding

Increased time taken to stop bleeding

Bruising

Loss of appetite

Nausea and vomiting

Skin rashes

Fever

Hair loss (alopecia)

Liver problems

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

The anticoagulant effect of acenocoumarol can be affected by many medicines. It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

The following medicines may enhance the effect of acenocoumarol (increased INR; acenocoumarol dose may need reducing):

allopurinol

amiodarone

antibiotic medicines (eg ampicillin, ciprofloxacin, co-trimoxazole, erythromycin, metronidazole)

antifungal medicines (eg fluconazole, ketoconazole, miconazole)

anabolic steroids (oxymetholone, stanozolol)

aspirin (may also irritate the stomach lining, which can result in bleeding from the stomach or intestine in people taking acenocoumarol)

certain chemotherapy regimens

cimetidine

danazol

dextropropoxyphene (found in co-proxamol/Distalgesic)

diflunisal

dipyridamole

disulfiram

fibrate medicines (eg bezafibrate, ciprofibrate, clofibrate)

flutamide

glucagon (large doses)

non-steroidal anti-inflammatory drugs (NSAIDs, eg ibuprofen and particularly azapropazone, diclofenac, flurbiprofen, indometacin, phenylbutazone, piroxicam. NSAIDs may also irritate the stomach and intestinal lining, which can result in bleeding from the gut in people taking acenocoumarol. The interaction does not generally apply to NSAIDs applied to the skin.)

omeprazole

paracetamol (long-term regular use, occassional painkilling doses should not affect acenocoumarol significantly)

propafenone

statins such as rosuvastatin, simvastatin

sulfinpyrazone

tamoxifen

thyroxine (levothyroxine).

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

aminoglutethimide

azathioprine

barbiturates, including phenobarbitone and primidone

carbamazepine

certain chemotherapy regimens

colestyramine

griseofulvin

oestrogens

progestogens

raloxifene

rifampicin

sucralfate

the herbal remeday St John's wort (Hypericum perforatum)

vitamin K.

The following medicines may also alter the effect of acenocoumarol and the dose of acenocoumarol may need to be adjusted up or down (as INR may be increased or reduced by the following medicines):

corticosteroids

phenytoin

quinidine

ritonavir.

This medicine may enhance the blood sugar lowering effect of antidiabetic tablets such as glibenclamide. Antidiabetic tablets may also enhance the anti-blood-clotting effect of this medicine. Combined use should be well monitored.

There may be an increased risk of bleeding if acenocoumarol is taken in combination with any of the following medicines.

antiplatelet or 'blood thinning' medicines such as aspirin, clopidogrel, dipyridamole

heparin

low molecular weight heparins, eg dalteparin

SSRI antidepressants such as paroxetine or fluoxetine.

Other medicines containing the same active ingredient

There are currently no other medicines available in the UK that contain acenocoumarol as the active ingredient.

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