Anisindione (brand name Miradon) is a synthetic anticoagulant and an indanedione derivative. It prevents the formation of anticoagulant proteins C and S, as well as active procoagulation factors II, VII, IX, and X in the liver by reducing the vitamin K. This results in inhibition of gamma-carboxylation of precursor protein glutamic acid to gamma-carboxyglutamic acid. The resultant effect of all these reactions in the body is prolongation of blood clotting time and reduced activity of clotting factors. Anisindione is used for treatment of atrial fibrillation with embolization, the prophylaxis and treatment of venous thrombosis, the prophylaxis and treatment of pulmonary embolism, disseminated intravascular coagulation and treatment of coronary occlusion.
Molecular Formula of Anisindione is C16H12O3
synonyms-2-(4-methoxyphenyl)-1H-indene-1,3(2H)-dione,2-para-Anisyl-1,3-indandione,2-(p-Methoxyphenyl)indane-1,3-dione, Unidone, Anisindionum
Methods of manufacturing
Anisindione is prepared from anisaldehyde and phthalide in sodium alcoholate. The alternate method of fabricating this compound is from 1-p-methoxybenzalphthalide and sodium methoxide.
Apart from hemorrhagic disorders, other adverse reactions include nausea and vomiting, abdominal cramps, diarrhea, pyrexia, anorexia, dermatitis or exfoliative dermatitis, sore throat, jaundice, hepatitis, anemia , liver damage, dermatitis, headache, urticaria, erythema and necrosis of the skin and other tissues alopecia, leukopenia, myeloid immaturity, paralysis of accommodation of eyes, sore mouth or mouth ulcers, priapism, albuminuria, eosinophilia, red cell aplasia, steatorrhearenal tubular necrosis, blurred vision, anuria, thrombo-cytopenia purple toes, atypical mononuclear cells, leukocytosis, leukocyte agglutinins, agranulocytosis, cutaneous gangrene and Phenprocoumon-induced delayed callus formation after bone fracture.
- History or tendency of bleeding, hemophilia, purpura, polycythemia vera, leukemia, cerebral hemorrhage which has taken place recently, ulcers in the the gastrointestinal tract, ulcerative colitis, wounds due to trauma or wounds from surgery
- recent or planned eye surgery, brain surgery, or surgery of spinal cord or prostatectomy
- Patients with continuous tube drainage of small gut
- Visceral carcinoma, severe kidney disease, severe liver disease, pericarditis, subacute bacterial endocarditis, diverticulitis, polyarthritis or aneurysm.
- malignant severe or hypertension, threatened abortion, preeclampsia or eclampsia,
- Malnutrition, emaciation, and vitamin K or C deficiencies.
- Pregnancy - Anisindione is not to be used during pregnancy as the drug travels across the placental barrier and can cause damage to fetus. Hemorrhage of neonate or Fetus and intrauterine fetal death have happened even when the level of prothrombin in mother were within the accepted range. Other disorders like hypoplasia of nasal structures, Conradi-Hunermann syndrome may occur. Other alternatives like heparin, which does not cross the placenta, need to be used in cases of pregnancy.