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Indanedione anticoagulant (vitamin K antagonist)

Phenindione

Brand names: Dindevan

Adult dose

Dose: Loading 200mg day 1, 100mg day 2, then maintain by INR (typically 50–150mg/day)
Route: PO
Frequency: OD

Clinical pearls

  • Reserved for warfarin-intolerant patients
  • Many drug interactions and idiosyncratic ADRs

Contraindications

  • Pregnancy
  • Active bleeding
  • Severe hepatic/renal impairment
  • Hypersensitivity

Side effects

  • Bleeding
  • Pink/orange urine discolouration
  • Hepatotoxicity
  • Agranulocytosis
  • Rash
  • Hypersensitivity

Interactions

  • Many — see BNF Appendix 1
  • NSAIDs
  • Antibiotics
  • Amiodarone

Monitoring

  • INR
  • FBC
  • LFTs

Reference: BNF; https://bnf.nice.org.uk/drugs/phenindione/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.