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Acenocoumarol therapy in pediatric patients

M Bonduel1, G Sciuccati, M Hepner

  • 1Departamento de Haematología-Oncología, Hospital de Pediatría 'Prof Dr Juan P. Garrahan', Combate de los Pozos 1881, Buenos Aires, Argentina. mbonduel@garrahan.gov.ar

Journal of Thrombosis and Haemostasis : JTH
|August 13, 2003
PubMed

Insights

Acenocoumarol dosing in children is age-dependent, with infants requiring higher doses than teenagers. Age-adjusted loading doses help pediatric patients reach the target therapeutic range faster, reducing hospitalization.

Area of Science:

  • Pediatric Pharmacology
  • Pharmacokinetics
  • Anticoagulant Therapy

Background:

  • Acenocoumarol is a vitamin K antagonist anticoagulant.
  • Establishing safe and effective dosing guidelines for pediatric patients is crucial.
  • Previous studies on pediatric acenocoumarol dosing are limited.

Purpose of the Study:

  • To establish age-specific guidelines for acenocoumarol administration in children.
  • To determine optimal loading and maintenance doses for pediatric patients.
  • To evaluate the efficacy and safety of an age-adjusted dosing regimen.

Main Methods:

  • Prospective evaluation of 93 pediatric patients over 33 months.
  • Dosing adjustments based on age groups: <1, 1-5, 6-10, and 11-18 years.
  • Monitoring of time to achieve and maintain target therapeutic range (TTR).

Main Results:

  • Loading doses varied significantly by age group, with infants requiring the highest doses.
  • 80% of patients achieved TTR within one week using age-adjusted loading doses.
  • No serious bleeding or thrombotic complications were reported.

Conclusions:

  • Pediatric response to acenocoumarol is age-dependent.
  • An age-adjusted loading dose regimen is effective in pediatric patients.
  • This approach reduces the time to achieve therapeutic anticoagulation and shortens hospital stays.

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