Антикоагулянт непрямого действия. Подавляет в печени синтез витамин К-зависимых факторов свертывания крови (II, VII, IX и X) и белков С и S в печени. Оптимальное антикоагулянтное действие наблюдается на 3-5 день от начала применения и прекращается через 3-5 дней после приема последней дозы.
Показания к применению
Лечение и профилактика тромбоза и тромбоэмболии сосудов:
Острый венозный тромбоз и тромбоэмболия легочной артерии
Послеоперационный тромбоз
Повторный инфаркт миокарда
В качестве дополнительного лекарственного средства при проведении хирургического или тромболитического лечения тромбоза, а также при электрической кардиоверсии мерцательной аритмии
Рецидивирующий венозный тромбоз
Повторная тромбоэмболия легочной артерии
Протезирование клапанов сердца и сосудов (возможна комбинация с ацетилсалициловой кислотой (АСК)
Тромбоз периферических, коронарных и мозговых артерий
Вторичная профилактика тромбоза и тромбоэмболии после инфаркта миокарда и при мерцании предсердий
Противопоказания
Острое кровотечение
Тяжелые заболевания печени
Тяжелые заболевания почек
Почечная недостаточность
Тяжелая артериальная гипертензия
Острый ДВС-синдром
Дефицит белков С и S
Геморрагический диатез
Тромбоцитопения
Язвенная болезнь желудка и двенадцатиперстной кишки в фазе обострения
Кровоизлияние в головной мозг
Алкоголизм
Беременность
Повышенная чувствительность к компонентам препарата
Способ применения и дозы
Препарат принимают внутрь, 1 раз/сут, в одно и то же время. Начальная доза - 2.5-5 мг/сут. Дальнейший режим дозирования устанавливают индивидуально в зависимости от результатов определения протромбинового времени или МНО. Протромбиновое время должно быть увеличено в 2-4 раза от исходного, а МНО должно достигать 2.2-4.4 в зависимости от заболевания, опасности тромбоза, риска развития кровотечений и индивидуальных особенностей пациента. При определении МНО следует учитывать индекс чувствительности тромбопластина и использовать этот показатель в качестве поправочного коэффициента (1.22 - при использовании отечественного тромбопластина из мозга кролика "Неопласт" и 1.2 - при использовании тромбопластина фирмы "Рош Диагностика"). Перед предстоящим хирургическим вмешательством (при высоком риске тромбоэмболических осложнений) лечение начинают за 2-3 дня до операции. В случае острого тромбоза лечение проводят в комбинации с гепарином до того момента, пока полностью не проявится эффект от пероральной антикоагулянтной терапии (не ранее чем на 3-5 сут лечения). При протезировании клапанов сердца, остром венозном тромбозе вен или тромбоэмболии (на начальных этапах), тромбозе левого желудочка и для профилактики ишемии миокарда нужно стремиться к эффективному действию, отмечающемуся при МНО - 2.8-4.0. В случае мерцания предсердий и при проведении поддерживающей терапии при тромбозе вен и тромбоэмболии добиваются умеренного противосвертывающего эффекта (МНО 2-3). При совместном применении варфарина с АСК показатель МНО должен находиться в пределах 2-2.5. Пациентам пожилого возраста и ослабленным больным препарат обычно назначают в более низких дозах. Продолжительность лечения зависит от состояния больного. Лечение можно отменять сразу.
Для описания товара использована информация от партнера 36.6
Мобильное приложение «Все аптеки»
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Информация предоставляется в справочных целях. Не занимайтесь самолечением. При первых признаках заболевания обратитесь к врачу.
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