Nicoumalone

Indigestion medicines known as proton pump inhibitors like omeprazole should be used with caution while taking Nicoumalone. Prolonged use of Nicoumalone can cause bleeding problems (like nosebleeds, heavier periods, bleeding gums, and easy bruising). If you are going to have any surgery, discontinue taking Nicoumalone 5 days before the surgery. Discontinuation of Nicoumalone might increase the risk of heart attack, stroke, and other risks of cardiovascular events. So, do not stop taking Nicoumalone of a sudden on your own decision. If you have had any recent stroke or heart attack, stop the intake of Nicoumalone with painkillers like aspirin or ibuprofen as it can increase your stomach or gastrointestinal bleeding. Purpura (blood leakage under the skin) has been observed with the use of Nicoumalone including fatal cases. If you are pregnant or planning for pregnancy or a nursing mother tell tour doctor that you are taking Nicoumalone.

Drug-Drug Interaction: Nicoumalone may have interaction with other anticoagulants (e.g. heparin, dipyridamole, clopidogrel, ticlopidine), anti-arrhythmic agents (e.g. amiodarone, quinidine), antibiotics (e.g. clindamycin), a medicine used against pain (e.g. diacetylsalicylic acid, aminosalicylic acid, diflunisal), an antidepressant (e.g. citalopram), HIV protease inhibitors (e.g. ritonavir, nelfinavir), protease inhibitors (e.g. indinavir, nelfinavir, ritonavir, saquinavir), barbiturates (e.g. Phenobarbital), antacids (e.g. magnesium hydroxide), and proton pump inhibitors (e.g. omeprazole).

Drug-Food Interaction: You should avoid drinking cranberry juice or taking other cranberry products also Nicoumalone may interact with herbs and supplements, including include garlic, ginger, bilberry, danshen, piracetam, ginkgo biloba and St John’s wort plant (used as an antidepressant) and increase the risk of bleeding. 

Drug-Disease Interaction: Nicoumalone should not be given to people with stomach ulcers, brain haemorrhage (bleeding in your brain), haemophilia (a bleeding disorder), and liver or kidney problems.

• Low cholesterol diet along with a regular exercise regime is found to complement treatment with Nicoumalone effectively.

• As a precautionary measure, you are recommended not to consume alcohol, junk food items from outside, stick to a freshly prepared home-cooked meal, and take proper rest, for a speedy recovery.

• And also try to replace most of your saturated fats with unsaturated fats can reduce total cholesterol and LDL cholesterol in a short span of time.

• Foods like avocados, olive oil, fatty fish, and nuts contain lots of heart-healthy unsaturated fats, so it’s beneficial to eat them regularly.

• Option for foods that are high in vitamin K (liver, leafy green vegetables, or vegetable oils) as Nicoumalone may lower Vitamin K in your body.

• Avoid drinking alcohol as it increases the risk of gastrointestinal ulcer/bleeding.

• Cranberry juice, grapefruit juice, noni juice, and pomegranate juice may interact with Nicoumalone and lead to unwanted side effects. Hence try to avoid these juices while taking Nicoumalone.

• Caution and more frequent monitoring of platelet count, factor V assay, fibrinogen level test, prothrombin time test (PT or PT-INR), and the INR, or international normalized ratio to analyze your blood clotting time.

• You should NOT receive any injections into your muscles whilst you are taking Nicoumalone. If you need any injections into your spine or as part of a scan or X-ray test or if you need minor surgery, including dental surgery, make sure you discuss your treatment with your doctor first.