Nicoumalone
About Nicoumalone
Nicoumalone is used to prevent and treat various types of thromboembolic diseases (blood clots inside blood vessels), including deep vein thrombosis (blood clots in leg veins) and pulmonary embolism (blood clots in the lung).
Nicoumalone is used to prevent unwanted clots from forming in conditions such as atrial fibrillation or after a heart valve replacement. It is also given to prevent any clots that may have already formed in the blood vessels of your legs, lungs, or heart from becoming larger and causing problems.
Nicoumalone contains Nicoumalone, which works by increasing the time it takes for your blood to clot, reducing the risk of a stroke or heart attack. This medication helps keep blood flowing smoothly in your body by decreasing the amount/number of clotting proteins in the blood.
Some people may experience unusual bleeding or a skin rash. Most of these side effects do not require medical attention and gradually resolve over time. However, if the side effects persist or worsen, please consult your doctor.
If you are known to be allergic to Nicoumalone or any other medicines, please tell your doctor. If you are pregnant, trying for a baby, or breastfeeding, it is advised to consult a doctor before using Nicoumalone. Nicoumalone does not dissolve blood clots that have already formed, but it may stop the clots from becoming larger and causing more serious problems.
Uses of Nicoumalone
Medicinal Benefits
- Nicoumalone is an oral anticoagulant (blood thinner) used to prevent and treat abnormal blood clot formation.
- It helps in the management of deep vein thrombosis (DVT), pulmonary embolism (PE), venous thromboembolism, and to reduce the risk of clot-related complications.
- It is beneficial in atrial fibrillation, where an irregular heart rhythm increases the risk of stroke due to clot formation.
- It is used in patients with mechanical heart valves to prevent valve-related blood clots.
- Nicoumalone works by inhibiting the action of vitamin K, thereby reducing the production of clotting factors in the liver.
- It prevents the conversion of fibrinogen (soluble protein) into fibrin (insoluble protein), stopping the formation of blood clots.
Directions for Use
- Nicoumalone can be taken with or without food, as advised by your doctor. However, avoid taking it with cranberry juice, as this may reduce the effectiveness of the medication.
- Your doctor may adjust the dosage and timing of Nicoumalone based on your health condition.
- Swallow Nicoumalone as a whole with a glass of water.
- Do not break, chew, or crush it.
Storage
Side Effects of Nicoumalone
- Unusual bleeding from the gums
- Heavy bleeding from cuts or wounds
- Unexplained bruising or nosebleeds
- Heavy periods
- Abdominal pain
- Blood vomiting
- Bloody or black tarry stools
- Blood in the urine
- Backache
- Dizziness
- Severe headache
- Weakness in an arm or leg
- Blurred vision
- A blood clot in the eye (visible pool of blood)
Drug Warnings
- Do not take Nicoumalone if you are allergic to any of its components.
- Inform your doctor if you have schizophrenia, dementia, very high blood pressure, stomach ulcers, liver or kidney problems, bleeding disorders or if you are due to undergo surgery.
- Consult your doctor before starting Nicoumalone if you are pregnant or planning for pregnancy or a nursing mother.
- Let your doctor know if you have cancer, an infection, an inflammation, an overactive thyroid, a blood disorder, or if you are taking any other medicines.
Drug Interactions
Drug-Drug Interaction: Nicoumalone may have interaction with other anticoagulants (heparin, dipyridamole, clopidogrel, ticlopidine), anti-arrhythmic agents (amiodarone, quinidine), antibiotics (clindamycin), a medicine used against pain (diacetylsalicylic acid, aminosalicylic acid, diflunisal), an antidepressant (citalopram), HIV protease inhibitors (ritonavir, nelfinavir), protease inhibitors (indinavir, nelfinavir, ritonavir, saquinavir), barbiturates (phenobarbital), antacids (magnesium hydroxide), and proton pump inhibitors (omeprazole).
Drug-Food Interaction: You should avoid drinking cranberry juice or taking other cranberry products, as Nicoumalone may interact with herbs and supplements, including garlic, ginger, bilberry, danshen, piracetam, ginkgo biloba and St John’s wort plant (used as an antidepressant) and increase the risk of bleeding.
Drug-Disease Interaction: Nicoumalone should not be given to people with stomach ulcers, brain haemorrhage (bleeding in your brain), haemophilia (a bleeding disorder), and liver or kidney problems.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
cautionYou are recommended to avoid the consumption of alcohol with Nicoumalone as it may increase the risk of bleeding.
Pregnancy
cautionNicoumalone is recommended not to be used in pregnancy. Your doctor will discuss with you the potential risk of taking Nicoumalone during pregnancy. Please consult your doctor.
Breast Feeding
cautionNicoumalone should not be taken until prescribed. Your doctor will weigh the benefits and any potential risks before prescribing them to you. Please consult your doctor. You and your child may require blood tests if you are breastfeeding while you are taking Nicoumalone. However, as a precaution, your doctor may prescribe vitamin K to your child to prevent their blood from being thinned.
Driving
safe if prescribedNicoumalone has no or negligible influence on the ability to drive or use machines.
Liver
cautionTake Nicoumalone with caution, especially if you have a history of Liver diseases/conditions. The dose may be adjusted by your doctor as required.
Kidney
cautionTake Nicoumalone with caution, especially if you have a history of Kidney diseases/conditions. The dose may be adjusted by your doctor as required.
Children
cautionNicoumalone should not be taken until prescribed. Your doctor will weigh the benefits and any potential risks before prescribing it to you. If Nicoumalone is used in children or adolescents, blood tests should be conducted more frequently to assess how well the medicine is working.
Habit Forming
Diet & Lifestyle Advise
- A low-cholesterol diet, along with a regular exercise regimen, is found to complement treatment with Nicoumalone effectively.
- As a precautionary measure, you are recommended not to consume alcohol, junk food items from outside, stick to a freshly prepared home-cooked meal, and take proper rest, for a speedy recovery.
- And also try to replace most of your saturated fats with unsaturated fats can reduce total cholesterol and LDL cholesterol in a short span of time.
- Foods like avocados, olive oil, fatty fish, and nuts contain lots of heart-healthy unsaturated fats, so it’s beneficial to eat them regularly.
- Opt for foods that are high in vitamin K (liver, leafy green vegetables, or vegetable oils) as Nicoumalone may lower Vitamin K in your body.
- Avoid drinking alcohol as it increases the risk of gastrointestinal ulcer/bleeding.
- Cranberry juice, grapefruit juice, noni juice, and pomegranate juice may interact with Nicoumalone and lead to unwanted side effects. Hence, try to avoid these juices while taking Nicoumalone.
Special Advise
- Caution and more frequent monitoring of platelet count, factor V assay, fibrinogen level test, prothrombin time test (PT or PT-INR), and the INR, or international normalised ratio, to analyse your blood clotting time.
- You should NOT receive any injections into your muscles whilst you are taking Nicoumalone. If you need any injections into your spine or as part of a scan or X-ray test, or if you need minor surgery, including dental surgery, make sure you discuss your treatment with your doctor first.
- If you are going to have any surgery, discontinue taking Nicoumalone 5 days before the surgery.
Patients Concern
Disease/Condition Glossary
Blood clots: Blood clots can occur in any part of the body, leading to a heart attack, stroke, and damage to organs (even coma or death). Blood clots can reach your arteries or veins in organs like the brain, kidneys, heart, lungs, and limbs. Conditions like atherosclerosis, diabetes, heart failure, irregular heartbeat (arrhythmia), and obesity/overweight can trigger excessive blood clotting in the brain and heart. On the other hand, deep vein thrombosis (a blood clot in the veins), peripheral artery disease (narrowed arteries due to fat deposits or blood clots), and atherosclerosis (fat built up on the walls of the arteries) can cause a blood clot in your limbs.
Deep vein thrombosis: Deep vein thrombosis (blood clots in the legs) is a medical condition in which blood clots form in deep veins, usually in the legs. The symptoms include leg pain or swelling.
Pulmonary embolism: Pulmonary embolism (blood clots in the lung) is a chronic condition that occurs when blood clots break and travel to the lungs from deep veins in the legs or other parts of the body. The symptoms of pulmonary embolism include cough, chest pain, and shortness of breath.
FAQs
Nicoumalone is used to prevent and treat various types of thromboembolic diseases (blood clots inside blood vessels), including deep vein thrombosis (blood clots in leg veins) and pulmonary embolism (blood clots in the lung).
Yes, taking Nicoumalone can increase the risk of bleeding as it contains aspirin, which is a blood thinner. So, please be very cautious while shaving, cutting fingernails or toenails, or using sharp objects to avoid any bleeding.
Nicoumalone works by increasing the time it takes for your blood to clot, reducing the risk of a stroke or heart attack.
Yes, Nicoumalone causes blood thinning. It works by preventing platelets (a type of blood cell) from sticking together and forming clots.
Please consult your doctor if Nicoumalone needs to be stopped before undergoing surgery. The doctor might ask you to stop taking Nicoumalone a few days before surgery to avoid the increased risk of bleeding during the procedure.
Do not take aspirin for pain relief or ibuprofen while you are taking Nicoumalone unless your doctor says it's OK. They raise the risk of unusual bleeding.
When a blood clot is treated, guidelines recommend that patients take blood thinners for the rest of their lives. If they do not, the chance of developing a second clot is 30 to 40 per cent in the next ten years.
There might be a problem if you take herbal therapies with Nicoumalone, especially those that affect the blood, like Ginkgo Biloba and St John's wort plant extract used as an antidepressant. Taking it together with other medications can increase your risk of bleeding. Tell your doctor if you are using any type of herbal supplement before taking Nicoumalone.
No, you are usually not advised to have a tattoo or body piercing while taking Nicoumalone as it may increase the risk of bleeding and infection. If you still wish to proceed further, contact your doctor so that the dose may be adjusted or any antibiotics may be prescribed, and let the piercer or tattooist know in advance that you are on treatment with a blood thinner.
No, you are not recommended to stop taking Nicoumalone without consulting your doctor, as it may worsen the condition. Therefore, take Nicoumalone for as long as your doctor has prescribed it.
You can have platelet count, factor V assay, fibrinogen level test, prothrombin time test (PT or PT-INR) and the INR, or international normalised ratio, to analyse your blood clotting time.
Nicoumalone may cause side effects like unusual bleeding or skin rash. Most of these side effects of Nicoumalone do not require medical attention and gradually resolve over time. However, if the side effects persist or worsen, please consult your doctor.
Nicoumalone can be taken with or without food, or as advised by the doctor.
