Fosinopril Acenocoumarol

Acenox, Acitrom, Sinthrome, Sintrom fosinopril captopril acenocoumarol perindopril captopril lisinopril perindopril... 

There is a single, isolated and unexplained case of melaena attributed to an interaction between acenocoumarol and fosinopril. No other ACE inhibitor studied has so far been shown to interact to a clinically relevant extent with the coumarins. 

A 74-year-old patient stabilised on acenocoumarol, enalapril, piretanide, and digoxin had the piretanide and enalapril switched to furosemide and fosinopril. Eleven days later, he presented with dark faeces (melaena) and had a low haemoglobin. Fosinopril and acenocoumarol were stopped, and then enalapril and acenocoumarol were restarted. On gastrointestinal endoscopy, no explanation for the melaena was found, and his haemoglobin level had returned to normal 15 days later. This case was attributed to possible potentiation of the effect of acenocoumarol by fosinopril, but as the drugs were not taken alone, the interaction is not proven. 

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See also in sourсe #XX -- [ ]

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