Acenocoumarol as an alternative anticoagulant in a patient with warfarin-related nephropathy
Sapan Kumar Behera1, Alphienes Stanley Xavier1, Sandhiya Selvarajan1
1Department of Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Adverse Event:
Warfarin-related nephropathy.
Drug Implicated:
Warfarin.
The Patient:
A 31-year-old female, managed with warfarin for rheumatic heart disease with atrial fibrillation.
Evidence That Links The Drug To The Event:
There were no alternative causes of nephropathy that could have caused the adverse event in this patient.
Management:
Shifting the drug from warfarin to acenocoumarol.
Mechanism:
Difference in renal elimination between warfarin and acenocoumarol.
Implication For Therapy:
Clinicians should be aware of this rare adverse effect of warfarin, and acenocoumarol can be considered as an alternative therapy for this condition.
Hypotheses To Be Tested:
Further prospectively designed studies are needed to consider acenocoumarol as an alternative therapy in warfarin-related nephropathy.
More Related Videos
Related Concept Videos
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Alternative RNA Splicing
There are five types of alternative RNA splicing that vary in the ways the pre-mRNA segments are removed or retained in the mature mRNA. The first...
Alternative RNA Splicing
Anticoagulant Drugs: Low-Molecular-Weight Heparins
Null and Alternative Hypotheses
The null hypothesis, denoted by H0 is a statement of no difference between the variables—they are not related. This can often be considered the status quo. As a result if you cannot accept the null, it requires some action.
The alternative hypothesis, denoted by H1 or Ha, is a claim about the...
Electric Generator: Alternator
The magnetic flux passing through the coil varies sinusoidally as the loop rotates inside the magnetic field. This...


