Uses of Tegrucil 1 mg

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1. Uses of Tegrucil 1 mg

What is Tegrucil 1 mg? The active ingredient is Acenocoumarol 1mg. Acenocoumarol is a vitamin A-resistant coumarin derivative, which has anticoagulant effects by indirectly preventing the synthesis of active forms of clotting factors II, VII, IX, X. Compared with warfarin and phenprocoumon, Acenocoumarol has the advantage of a shorter duration of action.
Indications for using Tegrucil 1 mg:
Heart disease causing embolism: Prevention of thromboembolic complications caused by mitral valve disease, prosthetic valve, atrial fibrillation; Myocardial infarction: Prophylaxis of thromboembolic complications in cases of myocardial infarction with complications such as severe left ventricular dysfunction, thrombus on the heart wall, left ventricular dysrhythmias causing embolism if continued treatment for heparin; prevention of recurrent myocardial infarction in patients unable to take aspirin; Treatment of deep vein thrombosis and pulmonary embolism, prevention of recurrence when continuing to replace heparin; Prophylaxis of thrombosis in catheters; Prevention of pulmonary embolism and venous thrombosis in hip surgery. Contraindications to the use of Tegrucil 1 mg:
Patients with hypersensitivity to coumarin derivatives or other components of the drug; People with vitamin C deficiency, blood dysplasia, bacterial endocarditis or blood disorders that increase the risk of bleeding; Patients with severe hypertension; Patients with liver failure, especially when prothrombin time is prolonged; People at risk of bleeding, recent surgical intervention on the eyes and nerves or the possibility of having to re-operate; Patients with cerebrovascular accident (except in case of blood vessel blockage elsewhere); Patients with severe renal failure, with ClCr less than 20ml/min; Patients with advanced gastric - duodenal ulcer; Patients with esophageal varices; Do not combine Tegrucil 1 mg with high-dose aspirin, systemic-vaginal miconazole, pyrazol, chloramphenicol, diflunisal, phenylbutazone non-steroidal anti-inflammatory drugs; Pregnant women and within 48 hours of giving birth.

2. Usage and dosage of Tegrucil 1 mg

How to use: Take Tegrucil 1 mg tablet whole with 1 glass of water.
Dosage: Needs to be adjusted to prevent coagulation to the point where thrombosis does not occur, but the risk of spontaneous bleeding should be avoided. Dosage is prescribed by the doctor depending on the individual patient's response to treatment. Specifically:
Usual dose: The first day is 4mg/day, the second day is 4-8mg/day. Maintenance dose is 1-8mg/day depending on biological response. Dosage adjustments are usually made in increments of 1 mg. Acenocoumarol will usually be taken once at the same time each day. Biological monitoring should be done to adjust the dose accordingly; Elderly: The starting dose is lower than the adult dose. The median therapeutic dose is 1⁄2 to 3⁄4 of the adult dose; Sequential heparin therapy: Due to the slow anticoagulant effect of vitamin K antagonists, heparin is maintained at a constant dose for the required time (i.e. until the INR is within the desired value for 2 consecutive days). ). If heparin-induced thrombocytopenia is present, vitamin K antagonists should not be started soon after stopping heparin because of the risk of increased coagulopathy due to premature reduction of protein S. Administer vitamin K antagonists only after taking antithrombin drugs; Children: The experience of using Tegrucil 1 mg in children is limited, so it should not be used for children; Patients with renal impairment: Tegrucil 1 mg is contraindicated in patients with severe renal impairment, caution should be exercised in patients with mild to moderate renal impairment; Hepatic impairment: The use of Tegrucil 1 mg is contraindicated in patients with severe hepatic impairment. Use caution in patients with mild and moderate hepatic impairment. Overdose: Management of an overdose of Tegrucil 1 mg is usually based on INR and signs of bleeding. Corrective measures are administered sequentially so as not to cause thrombosis. If anticoagulation has been stopped but vitamin K is not taken, the INR should be retested 2-3 days later to ensure that the INR has decreased.
Missed dose: The anticoagulant effect of Acenocoumarol lasts for more than 24 hours. If the patient forgets to take the medicine on time, it should be taken at the earliest possible time on the same day. At the same time, the patient should notify the doctor for follow-up.

3. Side effects of Tegrucil 1 mg

When using Tegrucil 1 mg, patients may experience some side effects such as:
Common: Bleeding gums, nosebleeds, hematoma, blood in urine, menstrual blood volume a lot, shortness of breath, fatigue, headache, unexplained discomfort,...; Uncommon: Diarrhea (may be accompanied by fatty stools), isolated joint pain; Rare: Localized skin necrosis, alopecia, allergic skin rash; Very rare: Vasculitis, liver damage. When experiencing side effects of Tegrucil 1 mg, patients should stop using the drug and notify the doctor for timely treatment.

4. Be careful when using Tegrucil 1 mg

Some notes patients need to remember before and while using Tegrucil 1 mg:
Pay attention to the patient's cognitive ability during treatment to avoid the risk of taking the wrong drug. Patients should be carefully instructed to follow the exact indications, understand the risks and have a handling attitude, especially with the elderly; Experience in using Tegrucil 1 mg in children is limited, do not use the drug for children; Emphasis on taking Tegrucil 1 mg every day at the same time; INR should be tested periodically and at the same place. In the case of surgical intervention, a case-by-case review should be made in order to adjust or temporarily discontinue anticoagulants. It should be based on the patient's thromboembolic risk and the bleeding risk associated with each type of surgery; Carefully monitor, adjust the dose of Tegrucil 1 mg appropriately in patients with renal failure, liver failure or hypoproteinaemia; Hemorrhagic complications are likely to occur in the first months of treatment with Tegrucil 1 mg. Should be closely monitored, especially if the patient returns home from the hospital, the drug should not be stopped suddenly; Tegrucil 1 mg preparation contains lactose monohydrate. This drug should not be used in patients with Lapp lactase deficiency, hereditary galactose intolerance or impaired absorption of glucose, galactose; There have been no reports on the effects of Tegrucil 1 mg when driving or operating machinery. Patients need to be careful and the risk of bleeding due to injury when using anticoagulants; The use of Tegrucil 1 mg drug is contraindicated in pregnant women because of the risk of fetal malformations, miscarriage. Women of childbearing age should use effective contraception while taking Acenocoumarol; Acenocoumarol passes into breast milk, so breast-feeding should be avoided while taking this medicine. If breast-feeding is required, vitamin K should be supplemented at the infant's daily dose.

5. Tegrucil 1 mg drug interactions

Many drugs can interact with vitamin K antagonists, it is necessary to monitor the patient for 3-4 days after adding/reducing the combination drug. Some drug interactions of Tegrucil 1 mg include:
Do not combine Tegrucil with Aspirin (high doses above 3g/day) because it will increase the anticoagulant effect and risk of bleeding (due to inhibition of platelet aggregation and metabolism). translation of anticoagulants from binding to plasma proteins); Do not combine Tegrucil with Miconazole because unexpected bleeding may be severe due to increased free form in the blood, inhibiting the metabolism of vitamin K antagonists; Do not combine Tegrucil with Phenylbutazone because of the increased anticoagulant effect associated with irritation of the gastrointestinal mucosa; Do not combine Tegrucil with non-steroidal anti-inflammatory drugs, pyrazol group because of the increased risk of bleeding due to platelet inhibition and irritation of the gastrointestinal mucosa; Tegrucil should not be combined with Chloramphenicol because it increases the effect of anticoagulants by reducing drug metabolism in the liver. If the combination cannot be avoided, check the INR more often, adjust the dose during and 8 days after stopping chloramphenicol; Tegrucil should not be combined with Diflunisal because of the increased anticoagulant effect due to competition for binding to plasma proteins. Patients should take other pain relievers such as Paracetamol; Certain drugs may increase the anticoagulant effect of Acenocoumarol: Allopurinol, benzbromarone, anabolic steroids, androgens, antiarrhythmics (amiodarone, quinidine, propafenon), antibiotics (amoxicillin, co-amoxiclav; macrolides such as erythromycin) , clarithromycin), second and third generation cephalosporins, metronidazole, quinolones (ciprofloxacin, norfloxacin, ofloxacin), neomycin, tetracyclines; Caution should be taken when co-administering Tegrucil with imidazole derivatives (econazole, fluconazole, ketoconazole), sulfonamides, fibrates, derivatives and structural fibrate analogues (fenofibrate, gemfibrozil), disulfiram, glucagon, ethacrynic acid, drugs. diabetes treatment (glibenclamide), sulphonylureas (tolbutamide and chlorpropamide), H2 antagonists (cimetidine), Paracetamol; Caution should be taken when co-administering Tegrucil with thyroid hormones (dextrothyroxine), statins (atorvastatin, fluvastatin, simvastatin), selective serotonin reuptake inhibitors (citalopram, fluoxetin, sertraline, paroxetin), tamoxifen, 5-fluorouracil, tramadol , proton pump inhibitors (omeprazole), plasminogen activators (urokinase, streptokinase, alteplase) thrombin inhibitors (argatroban), pentoxifylin, orlistat, peristaltic agents (cisapride), antacids (magnesium hydroxide), viloxazine , CYP2C9 inhibitor; Drugs that may reduce the anticoagulant effect of Acenocoumarol: Bosentan, aminoglutethimide, sucralfate, anticancer drugs (azathioprine, 6 mercaptopurine, tamoxifen, raloxifene), barbiturates (phenobarbital), cholestyramine, carbamazepine, griseofulvin, rifampicin, preventive medicine oral pregnancy, HIV protease inhibitors (ritonavir, nelfinavir), thiazide diuretics, inducers of CYP2C9, CYP3A4 or CYP2C19, vitamin E and corticosteroids (methylprednisolone, prednisone); Drugs that may increase or decrease the anticoagulant effect of Acenocoumarol: Indinavir, nelfinavir, saquinavir, ritonavir, lopinavir, nevirapine, efavirenz; Acenocoumarol when used concurrently with hydantoin derivatives such as phenytoin increases the serum concentration of hydantoin; Acenocoumarol when used concurrently with derivatives such as glibenclamide, glimepiride increases the hypoglycemic effect; Alcohol can affect the effect of Tegrucil 1 mg, so patients should not drink alcohol while taking the drug; Avoid foods or beverages made from cranberries when taken with Tegrucil 1 mg because of the increased risk of anticoagulants. When using Tegrucil 1 mg, patients should follow all of their doctor's instructions to ensure effective treatment and reduce the risk of dangerous side effects.

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