Acenocoumarol
Acenocoumarol is an oral anticoagulant (blood thinner) belonging to the coumarin class that works by inhibiting vitamin K-dependent clotting factors. It is primarily used to prevent and treat harmful blood clots in conditions such as deep vein thrombosis, pulmonary embolism, atrial fibrillation, and in patients with mechanical heart valves. Regular blood monitoring (INR) is essential to ensure safe and effective dosing.
Acenocoumarol is a vitamin K antagonist anticoagulant used to prevent and treat blood clots in high-risk patients.
Key facts at a glance
- ATC
- B01AA07
- RxNorm
- 154
- Generic
- Acenocoumarol
- Class
- atc-b01
- Brands
- —
- Availability
- rx
- Lactation
- unknown
- Routes
- oral
- Forms
- tablet
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 500mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 250mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 400mg daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
8 groupspregnancy
first trimesteravoid if possible
avoid use during pregnancy unless benefits outweigh risks, coumarin derivatives are teratogenic
regular fetal monitoring, ultrasound to detect fetal abnormalities
Use of this medication in this population requires careful consideration of risks and benefits.
pregnancy
second trimesteravoid if possible
discontinue before second trimester if possible, consider switching to heparin
fetal growth monitoring, regular ultrasound
Use of this medication in this population requires careful consideration of risks and benefits.
pregnancy
third trimesterdiscontinue before delivery
switch to heparin before delivery to reduce bleeding risk during labor
fetal monitoring, plan for controlled delivery
Use of this medication in this population requires careful consideration of risks and benefits.
lactation
breastfeedingavoid
acenocoumarol is excreted in breast milk, breastfeeding should be avoided
infant monitoring for bleeding signs, consider infant PT/INR if symptoms
Use of this medication in this population requires careful consideration of risks and benefits.
geriatric
elderly over 65start at lower end of dosing range
increased sensitivity to anticoagulant effects, higher risk of bleeding complications, increased fall risk
frequent INR monitoring, renal function assessment
Use with caution and monitor for adverse effects.
pediatric_age
childrenweight-based dosing, individualize
requires specialized pediatric dosing, close monitoring, often used in pediatric cardiology for cardiac conditions
frequent INR monitoring, growth monitoring in children
Use with caution and monitor for adverse effects.
renal_impairment
moderatemay require dose reduction, closer monitoring
impaired renal function affects drug elimination, increased bleeding risk
frequent INR monitoring, regular renal function assessment
Use with caution and monitor for adverse effects.
hepatic_impairment
moderatelikely dose reduction required
impaired liver function affects synthesis of clotting factors and drug metabolism, enhanced anticoagulant effect
frequent INR monitoring, liver function tests
Use with caution and monitor for adverse effects.
Statistics and clinical data
Commonly prescribed since
General prescribing information
Drug class
Drug class information
Common uses
Common therapeutic uses
Mechanism of action
Pharmacological mechanism
Prevention and treatment of venous thromboembolism (deep vein thrombosis and pulmonary embolism), prevention of stroke and systemic embolism in patients with atrial fibrillation, and prevention of thromboembolism in patients with mechanical heart valves.
Acenocoumarol inhibits vitamin K epoxide reductase (VKORC1), blocking the regeneration of active vitamin K and reducing synthesis of vitamin K-dependent clotting factors (II, VII, IX, X) and anticoagulant proteins C and S.
Requires regular INR monitoring to maintain therapeutic range; has a shorter half-life than warfarin but similar bleeding risks; many drug and food interactions; patients should avoid sudden changes in vitamin K intake; bleeding precautions are essential; dose adjustments must be made by a healthcare provider.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed August 24, 2026. · Read our editorial policy