- Dosages
- Side effects in children
- Warnings & precautions in children
- Contra-indications in children
-
Interactions - PK
- Renal impairment
- References
Pharmacokinetics in children
No information
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dose recommendation of formulary compared to licensed use (on-label versus off-label)
No information is present at this moment.
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Available formulations
No information is present at this moment.
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Dosages
| Anticoagulation |
|---|
|
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Renal impaiment in children > 3 months
Adjustment in renal impairment as specified:
GFR 50-80 ml/min/1.73 m2
Dose adjustment is not required.GFR 30-50 ml/min/1.73 m2
Dose adjustment is not required.GFR 10-30 ml/min/1.73 m2
Consider lowering the loading dose.GFR < 10 ml/min/1.73 m2
Generalized recommendations cannot be given.Clinical consequences
Haemorrhages.
In a study with warfarin, patients whose creatinine clearance was less than 30 ml/min needed a lower warfarin dosage to achieve an INR inside the target range than patients with better renal function. In addition, bleeding occurred more often in these patients and they often had an INR outside the target range.
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The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here
Side effects in children
Tendency to bleed.
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The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here
Contra-indications in children
Punctures, biopsies and operations are contraindicated during coumarin use.
The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here
Warnings & precautions in children
It takes 5-7 days for the therapy to be stable. Watch out for a tendency to bleed. In cases of bleeding when coumarin is used, phytomenadione can be administered as an antidote. It takes about 3 hours before the phytomenadione takes effect. If the effect is not fast enough, prothrombin complex can be used.
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Interactions
The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here
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| Vitamin K antagonists | ||
|---|---|---|
| B01AA04 | ||
| Heparin group | ||
|---|---|---|
| B01AB04 | ||
| B01AB09 | ||
| B01AB05 | ||
| B01AB01 | ||
| B01AB06 | ||
| B01AB10 | ||
| Platelet aggregation inhibitors excl. heparin | ||
|---|---|---|
| B01AC06 | ||
| B01AC04 | ||
| B01AC09 | ||
| Enzymes | ||
|---|---|---|
| B01AD02 | ||
| B01AD01 | ||
| B01AD04 | ||
| Direct thrombin inhibitors | ||
|---|---|---|
| B01AE07 | ||
| Direct factor Xa inhibitors | ||
|---|---|---|
| B01AF02 | ||
| B01AF01 | ||
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References
- Rademaker C.M.A. et al, Geneesmiddelen-Formularium voor Kinderen, 2007
- NVK., Werkboek Kinderhematologie, http://www.hematologienederland.nl, 30 sept 2012, Geraadpleegd 03-02-2014
- Spoor N et al, Phenprocoumon and acenocoumarol treatment in paediatric patients., Thromb Haemost. 2, 012, Dec;108(6):, 1238-41
- NVK, Diagnostiek en behandeling van veneuze trombo-embolie bij kinderen, www.nvk.nl, jan 2014
- Nederlandse Vereniging voor Kindergeneeskunde, sectie kinderhematologie, Richtlijn Diagnostiek en behandeling van veneuze trombo-embolische complicaties bij neonaten en kinderen tot 18 jaar, https://hematologienederland.nl/kwaliteit/werkboek-kinderhematologie/, 2020, Jan, Rev1
- Rademaker C.M.A. et al, Geneesmiddelen-Formularium voor Kinderen, 2007
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Changes
Changes
