Acenocoumarol
152-72-7CC(=O)CC(c1ccc([N+](=O)[O-])cc1)c1c(O)c2ccccc2oc1=OVABCILAOYCMVPS-UHFFFAOYSA-NAcenocoumarol is a hydroxycoumarin that is warfarin in which the hydrogen at position 4 of the phenyl substituent is replaced by a nitro group. It has a role as an anticoagulant and an EC 1.6.5.2 [NAD(P)H dehydrogenase (quinone)] inhibitor. It is a C-nitro compound, a hydroxycoumarin and a methyl ketone.
152-72-7DTXSID2022541CHEMBL397420CHEBI:53766log Kow = 1.98
1.98
1.98
Crystals
White crystaline powder
OFF-WHITE TO LIGHT-TAN POWDER
practically insoluble
Sparingly soluble in most organic solvents
SOL IN SOLN OF ALKALI HYDROXIDES
Soluble in alcohol
In water, 9.39 mg/l @ 20 to 25 °C
1.06e-02 g/L
Breast Feeding; Lactation; Anticoagulants
Pharmaceuticals
Medicines affecting coagulation
196-199
196-199 °C
197 °C
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Danger
H302 (100%): Harmful if swallowed [Warning Acute toxicity, oral]
P203, P261, P264, P264+P265, P270, P271, P280, P301+P317, P302+P352, P304+P340, P305+P351+P338, P318, P319, P321, P330, P332+P317, P337+P317, P362+P364, P403+P233, P405, and P501 (click each P-code to see the statement)
Aggregated GHS information provided per 46 reports by companies from 6 notifications to the ECHA C&L Inventory. Each notification may be associated with multiple companies.
Adverse effects of anticoagulants on fetal development is considered.[Folb PI et al; Drug Safety in Pregnancy 221-32 (1990)]
Schardein JL; Drugs Affecting Blood. Chemically Induced Birth Defects 2: 106-25 (1993). Review of the fetal toxicity of anticoagulants.
SRP: At the time of review, criteria for land treatment or burial (sanitary landfill) disposal practices are subject to significant revision. Prior to implementing land disposal of waste residue (including waste sludge), consult with environmental regulatory agencies for guidance on acceptable disposal practices.
B01AA07
B - Blood and blood forming organs
QB - Blood and blood forming organs
Acenocoumarol inhibits the reduction of vitamin K by vitamin K reductase. This prevents carboxylation of certain glutamic acid residues near the N-terminals of clotting factors II, VII, IX and X, the vitamin K-dependent clotting factors. Glutamic acid carboxylation is important for the interaction between these clotting factors and calcium. Without this interaction, clotting cannot occur. Both the extrinsic (via factors VII, X and II) and intrinsic (via factors IX, X and II) are affected by acenocoumarol.
Acenocoumarol inhibits vitamin K reductase, resulting in depletion of the reduced form of vitamin K (vitamin KH2). As vitamin K is a cofactor for the carboxylation of glutamate residues on the N-terminal regions of vitamin K-dependent clotting factors, this limits the gamma-carboxylation and subsequent activation of the vitamin K-dependent coagulant proteins. The synthesis of vitamin K-dependent coagulation factors II, VII, IX, and X and anticoagulant proteins C and S is inhibited resulting in decreased prothrombin levels and a decrease in the amount of thrombin generated and bound to fibrin. This reduces the thrombogenicity of clots.
The oral anticoagulants block the regeneration of reduced vitamin K and thereby induce a state of functional vitamin K deficiency. The mechanism of the inhibition of reductase(s) by the coumarin drugs is not known. There exist reductases that are less sensitive to these drugs but that act only at relatively high concentrations of oxidized vitamin K; this property may explain the observation that administration of sufficient vitamin K can counteract even large doses of oral anticoagulants. /Oral Anticoagulants/
Both 4-hydroxycoumarin derivatives and indandiones (also known as oral anticoagulants) are antagonists of vitamin K. Their use as rodenticides is based on the inhibition of the vitamin K-dependent step in the synthesis of a number of blood coagulation factors. The vitamin K-dependent proteins ...in the coagulation cascade... are the procoagulant factors II (prothrombin), VII (proconvertin), IX (Christmas factor) and X (Stuart-Prower factor), and the coagulation-inhibiting proteins C and S. All these proteins are synthesized in the liver. Before they are released into the circulation the various precursor proteins undergo substantial (intracellular) post-translational modification. Vitamin K functions as a co-enzyme in one of these modifications, namely the carboxylation at well-defined positions of 10-12 glutamate residues into gamma-carboxyglutamate (Gla). The presence of these Gla residues is essential for the procoagulant activity of the various coagulations factors. Vitamin K hydroquinone (KH2) is the active co-enzyme, and its oxidation to vitamin K 2,3-epoxide (KO) provides the energy required for the carboxylation reaction. The epoxide is than recycled in two reduction steps mediated by the enzyme KO reductase... . The latter enzyme is the target enzyme for coumarin anticoagulants. Their blocking of the KO reductase leads to a rapid exhaustion of the supply of KH2, and thus to an effective prevention of the formation of Gla residues. This leads to an accumulation of non-carboxylated coagulation factor precursors in the liver. In some cases these precursors are processed further without being carboxylated, and (depending on the species) may appear in the circulation. At that stage the under-carboxylated proteins are designated as descarboxy coagulation factors. Normal coagulation factors circulate in the form of zymogens, which can only participate in the coagulation cascade after being activated by limited proteolytic degradation. Descarboxy coagulation factors have no procoagulant activity (i.e. they cannot be activated) and neither they can be converted into the active zymogens by vitamin K action. Whereas in anticoagulated humans high levels of circulating descarboxy coagulation factors are detectable, these levels are negligible in warfarin-treated rats and mice. /Anticoagulant rodenticides/
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The primary antidote to acenocoumarol poisoning is immediate administration of vitamin K1 (initially slow intravenous injections of 10-25 mg repeated all 3-6 hours until normalisation of the prothrombin time; then 10 mg orally four times daily as a "maintenance dose"). It is an extremely effective antidote, provided the poisoning is caught before too much damage has been done to the victim's circulatory system. At high doses acenocoumarol can affect the body for many months, and the antidote must be administered regularly for a long period of time. (L1257)
CORTICOTROPIN & ADRENOCORTICOSTEROIDS HAVE BEEN REPORTED TO CAUSE SEVERE HEMORRHAGE WHEN GIVEN WITH ORAL ANTICOAGULANTS... /ANTICOAGULANTS/
SULFONAMIDES HAVE BEEN REPORTED TO ENHANCE EFFECTS OF ORAL ANTICOAGULANTS... /ORAL ANTICOAGULANTS/
IN PRESENCE OF CHOLESTYRAMINE, REDN IN SERUM WARFARIN LEVELS & ASSOC REDUCED HYPOPROTHROMBINEMIC EFFECT... OTHER COUMARIN DERIV (EG, ACENOCOUMAROL...)...MAY BE EXPECTED TO INTERACT WITH CHOLESTYRAMINE...
RIFAMPIN HAS BEEN DOCUMENTED AS CAUSING REDN OF EFFECTS OF ORAL ANTICOAGULANTS (ACENOCOUMAROL...).
For more Interactions (Complete) data for ACENOCOUMAROL (29 total), please visit the HSDB record page.
Acenocoumarol inhibits vitamin K reductase, resulting in depletion of the reduced form of vitamin K (vitamin KH2). As vitamin K is a cofactor for the carboxylation of glutamate residues on the N-terminal regions of vitamin K-dependent proteins, this limits the gamma-carboxylation and subsequent activation of the vitamin K-dependent coagulant proteins. The synthesis of vitamin K-dependent coagulation factors II, VII, IX, and X and anticoagulant proteins C and S is inhibited. Depression of three of the four vitamin K-dependent coagulation factors (factors II, VII, and X) results in decresed prothrombin levels and a decrease in the amount of thrombin generated and bound to fibrin. This reduces the thrombogenicity of clots. (A308)
The onset and severity of the symptoms are dependent on the individual's sensitivity to oral anticoagulants, the severity of the overdosage, and the duration of treatment. Bleeding is the major sign of toxicity with oral anticoagulant drugs. The most frequent symptoms observed are: cutaneous bleeding (80%), haematuria (with renal colic) (52%), haematomas, gastrointestinal bleeding, haematemesis, uterine bleeding, epistaxis, gingival bleeding and bleeding into the joints. Further symptoms include tachycardia, hypotension, peripheral circulatory disorders due to loss of blood, nausea, vomiting, diarrhoea and abdominal pains.
/HUMAN EXPOSURE STUDIES/ Incidence of hemorrhage is 2-4%. ...Bleeding is most common from mucous membranes, skin, and GI and genitourinary tracts.
/HUMAN EXPOSURE STUDIES/ Acenocoumarol may cause dermatitis...leukopenia, alopecia, and elevated plasma transaminase concentration.
/HUMAN EXPOSURE STUDIES/ Reported toxic effects including ulceration of mouth and gastrointestinal irritation.
/HUMAN EXPOSURE STUDIES/ Bleeding is the major toxicity of oral anticoagulant drugs. Especially serious episodes involve sites where irreversible damage may result from compression of vital structures (e.g., intracranial, pericardial, nerve sheath, or spinal cord) or from massive internal blood loss that may not be diagnosed rapidly (e.g., gastrointestinal, intraperitoneal, retroperitoneal). /Oral Anticoagulants/
For more Human Toxicity Excerpts (Complete) data for ACENOCOUMAROL (6 total), please visit the HSDB record page.
Drug-Induced Liver Injury Severity and Toxicity (DILIst)
acenocoumarol
DILI Positive
Oral
DOI:10.1016/j.drudis.2019.09.022
Persons with a history of blood disorders with bleeding tendencies, would be expected to be at increased risk from exposure. /Warfarin/
There is evidence that treatment with coumarin drugs during pregnancy causes nasal hypoplasia and stippled epiphyses (chondrodysplasia punctata) in the fetus, and when taken late in pregnancy may cause optic atrophy and microcephaly. /Coumarin drugs/
SRP: Persons with bleeding disorders or who are taking anticoagulants should be protected from exposure.
Vitamin K1 is a specific antidote for anticoagulants, such as anisindione, which reduce prothrombin activity in the blood. Vitamin K1 may be administered orally or by injection, if the patient is not bleeding or if bleeding is slight. A few hours after the administration of vitamin K1 preparations, such as phytonadione, prothrombin activity increases and clotting time decreases. In the presents of more active hemorrhage, however, transfusions of whole blood or plamsa are required until the desired level of prothrombin activity is achieved. Treatment with vitamin K1 is the only adjunctive in such cases.
8 to 11 hours.
8 to 11 hours.
Acenocoumarol has a short half-life of 10 to 24 hours.
Extensively metabolized in the liver via oxidation forming two hydroxy metabolites and keto reduction producing two alcohol metabolites. Reduction of the nitro group produces an amino metabolite which is further transformed to an acetoamido metabolite. Metabolites do not appear to be pharmacologically active.
Extensively metabolized in the liver via oxidation forming two hydroxy metabolites and keto reduction producing two alcohol metabolites. Reduction of the nitro group produces an amino metabolite which is further transformed to an acetoamido metabolite. Metabolites do not appear to be pharmacologically active. Route of Elimination: Mostly via the kidney as metabolites Half Life: 8 to 11 hours.
Rapidly absorbed orally with greater than 60% bioavailability. Peak plasma levels are attained 1 to 3 hours following oral administration.
Mostly via the kidney as metabolites
The volume of distribution at steady-state appeared to be significantly dose dependent: 78 ml/kg for doses < or = 20 microg/kg and 88 ml/kg for doses > 20 microg/kg respectively
ACENOCOUMAROL IS LARGELY EXCRETED BY KIDNEYS, IN UNCHANGED FORM.
Rats received sc 1 mg doses of the R- or S-enantiomers of acenocoumarol and biliary and urinary excretion patterns were studied. In 24 hr, 50% biliary and 20% urinary excretion was observed with no gross differences in metabolic pattern or amount of metabolites. Slight differences due to stereochemistry are /noted/.
MEDICATION
Acenocoumarol is an anticoagulant drug derived from coumarin. (L1261) For the treatment and prevention of thromboembolic diseases. More specifically, it is indicated for the for the prevention of cerebral embolism, deep vein thrombosis, pulmonary embolism, thromboembolism in infarction and transient ischemic attacks. It is used for the treatment of deep vein thrombosis and myocardial infarction.
VerwendenR-Enantiomer of Acenocoumarol. Vitamin K antagonist; structurally similar to Warfarin. Anticoagulant
DefinitionChEBI: A hydroxycoumarin that is warfarin in which the hydrogen at position 4 of the phenyl substituent is replaced by a nitro group.