Pharmacotherapeutic group: Antithrombotic, vitamin K antagonists. ATC code: B01AA07
Mechanism of action
Acenocoumarol is a coumarin derivative and functions as vitamin K antagonist. Vitamin K antagonists produce their anticoagulant effect by inhibition of the vitamin K-epoxide-reductase with a subsequent reduction of the gamma-carboxylation of certain glutamic acid molecules which are located at several sites near the terminal end both of coagulation factors II (prothrombin), VII, IX, and X and of protein C or its cofactor protein S.
Pharmacodynamic effects
This gamma-carboxylation has a significant bearing on interaction of the aforementioned coagulation factors with Calcium ions. Without this reaction, blood clotting cannot be initiated.
Clinical efficacy and safety
Depending on the initial dosage, Sinthrome prolongs the thromboplastin time within approximately 36 to 72 hours. Following withdrawal of Sinthrome, the thromboplastin time usually reverts to normal after a few days.
