Swissmedic Nr.: 19395014
Index: 06.03.10
Pharmacode: 1350535
GTIN/EAN: 7680193950141
Markteintritt: k.a.
Kategorie: A Einmalige Abgabe auf eine ärztliche Verschreibung hin.
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Marcoumar setzt die Gerinnungsneigung des Blutes herab und verhindert so die Bildung von Blutgerinnseln (Thromben), welche die Blutbahn verstopfen können.
Die Behandlung mit diesem Arzneimittel nennt man auch «Blutverdünnung», welche meist über längere Zeit durchgeführt werden muss. Dabei ist eine genaue Kontrolle der Arzneimitteleinwirkung erforderlich, weil eine zu starke oder zu schwache «Blutverdünnung» gefährlich sein kann.
Ihr Arzt oder Ihre Ärztin wird mit speziellen Blutuntersuchungen (Bestimmung des INR-Wertes) die Gerinnungsneigung Ihres Blutes messen und danach die erforderliche Einnahmemenge von Marcoumar festlegen. Seine resp. ihre Anweisungen müssen Sie genau befolgen.
Marcoumar darf nur auf Verschreibung des Arztes oder der Ärztin angewendet werden.
Sie erhalten von Ihrem Arzt oder Ihrer Ärztin einen Antikoagulantienausweis. Tragen Sie diesen während der ganzen Behandlungsdauer sorgfältig bei sich. In gewissen Fällen (zum Beispiel bei Reisen in Gegenden mit unsicherer ärztlicher Versorgung) gibt Ihnen Ihr Arzt oder Ihre Ärztin ein geeignetes Gegenmittel (zum Beispiel mit dem Wirkstoff Phytomenadion = Vitamin K1), das Sie auf sich tragen sollen. Er oder sie wird Sie über die Verwendung instruieren.
Marcoumar darf nicht angewendet werden bei Überempfindlichkeit gegenüber einem der Inhaltsstoffe, bei Blutungsneigung, schweren Blutgerinnungsstörungen (z.B. Hämophilie), schweren Leber- oder Nierenschäden, Magen-Darm-Geschwüren, starkem Bluthochdruck und Schwangerschaft. Auch vor und nach gewissen operativen Eingriffen und therapeutischen Verfahren, welche zu unkontrollierbaren Blutungen führen könnten, darf Marcoumar nicht eingenommen werden.
Marcoumar ist ein sehr wirksames Arzneimittel. Seine Wirkung muss aber genau kontrolliert werden. Halten Sie sich daher an die mit Ihrem Arzt oder Ihrer Ärztin vereinbarten Blutkontrollen und achten Sie darauf, dass Sie die vorgeschriebenen Mengen Marcoumar zur richtigen Zeit einnehmen.
Es ist wichtig, dass Sie alle Sie behandelnden Ärzte über die Einnahme von Marcoumar sowie über geplante Operationen, bestimmte therapeutische Eingriffe (z.B. Angiographien, Lumbalpunktion, Zahnextraktionen), allfällige schwere Erkrankungen (insbesondere Herzerkrankungen und hoher Blutdruck) und weitere Krankheiten (Diabetes, Schilddrüsenüberfunktion, Tumoren, Nierenerkrankungen, Infektionen und Entzündungen) informieren.
Zusätzliche Arzneimittel dürfen ohne Wissen des Arztes oder der Ärztin nicht eingenommen oder abgesetzt werden, da sie die Wirkung von Marcoumar verändern können. Dies gilt auch für pflanzliche Medikamente, insbesondere Präparate, die Johanniskraut-Extrakte (Hypericum perforatum) enthalten. Sprechen Sie mit Ihrem Arzt oder Ihrer Ärztin, bevor Sie Schmerzmittel, Grippemittel, Rheumamittel, harntreibende Medikamente, Alkoholentwöhnungsmittel, Antidepressiva, Antibiotika, Narkosemittel, Arzneimittel, welche die Blutgerinnung beeinflussen (z.B. Heparin, Clopidogrel), Arzneimittel gegen Herzrhythmusstörungen, Schilddrüsenstörungen, Krebs, Sodbrennen, Krämpfe (Epilepsie), Zuckerkrankheit, Gicht, Tuberkulose, entzündungshemmende Arzneimittel, Cholesterinsenker, muskelbildende Substanzen, Vit. K-haltigen Präparaten, Glukosamin oder andere Arzneimittel einnehmen. Er oder sie kann beurteilen, welche Arzneimittel am besten eingesetzt werden.
Alle diese Massnahmen sollen verhindern, dass Blutungen auftreten. Sollten Sie dennoch stärkeres Zahnfleischbluten, Nasenbluten, Blut im Urin oder schwarzen Stuhl feststellen, so benachrichtigen Sie unverzüglich Ihren Arzt oder Ihre Ärztin. Auch bei leichteren Blutungen sollten Sie Ihren Arzt oder Ihre Ärztin darauf aufmerksam machen.
Wenn Sie einen Unfall erleiden, so teilen Sie dem behandelnden Arzt oder der behandelnden Ärztin mit, dass Sie Blutgerinnungshemmer (Antikoagulantien) einnehmen. Tragen Sie deshalb auch immer Ihren Antikoagulantienausweis auf sich.
Sollten Sie aus irgendeinem Grund einen anderen als Ihren Hausarzt oder Ihre Hausärztin benötigen, machen Sie ihn oder sie darauf aufmerksam, dass Sie Marcoumar einnehmen und daher keine Spritzen in die Muskeln erhalten dürfen.
Auch Ihrem Zahnarzt oder Ihrer Zahnärztin sollten Sie vor der Behandlung mitteilen, dass Sie Marcoumar einnehmen.
Wenn Sie eine längere Reise planen, sprechen Sie vorher mit Ihrem Arzt oder Ihrer Ärztin.
Während der Behandlung mit Marcoumar soll auf eine ausgeglichene Ernährung geachtet werden. Auf unregelmässige Einnahme grösserer Mengen von Lebensmitteln mit hohem Vitamin-K-Gehalt (z.B. Spinat, verschiedene Kohlsorten, insbesondere Broccoli) sollte verzichtet werden, da dies die Wirkung von Marcoumar abschwächen kann. Grapefruits können das Blutungsrisiko verstärken. Die gleichzeitige Einnahme von Goji-Beeren oder -Saft könnte die Wirkung von Marcoumar verstärken.
Ebenso sollten Sie den übermässigen Genuss von Alkohol vermeiden, da Alkohol die Wirkung von Marcoumar verändern kann. Marcoumar Tabletten enthalten Laktose. Teilen Sie Ihrem Arzt bzw. Ihrer Ärztin vor der Einnahme von Marcoumar mit, wenn Sie an einer Laktose-Unverträglichkeit leiden.
Informieren Sie Ihren Arzt oder Apotheker bzw. Ihre Ärztin oder Apothekerin, wenn Sie:
Marcoumar darf nicht während der Schwangerschaft angewendet werden. Wenn Sie während der Behandlung mit Marcoumar schwanger werden, stellt dies für Ihr werdendes Kind eine Gefahr dar. Falls Sie also bemerken, dass eine Schwangerschaft eingetreten ist, informieren Sie sofort Ihren Arzt oder Ihre Ärztin. Sprechen Sie ebenfalls mit Ihrem Arzt oder Ihrer Ärztin, wenn Sie die Absicht haben, schwanger zu werden.
Frauen im gebärfähigen Alter müssen wirksame Verhütungsmassnahmen während der Behandlung und bis zu 3 Monate nach der Behandlung anwenden.
Marcoumar darf während der Stillzeit nur auf Anweisungen des Arztes oder der Ärztin eingenommen werden.
Die tägliche Dosis ist von Patient zu Patient resp. von Patientin zu Patientin verschieden und wird durch die Bluttests von Ihrem Arzt oder Ihrer Ärztin ermittelt.
Ändern Sie nicht von sich aus die verschriebene Dosierung. Wenn Sie glauben, das Arzneimittel wirke zu schwach oder zu stark, so sprechen Sie mit Ihrem Arzt oder Apotheker bzw. mit Ihrer Ärztin oder Apothekerin.
Die Tabletten unzerkaut mit etwas Flüssigkeit einnehmen.
Die Anwendung und Wirksamkeit von Marcoumar bei Patienten unterhalb 14 Jahren sind bisher nicht geprüft worden.
Wenn Sie die Einnahme von Marcoumar zum vorgesehenen Zeitpunkt vergessen haben, nehmen Sie die vorgesehene Dosis sobald wie möglich am geplanten Tag ein. Wenn Sie jedoch das Vergessen erst am nächsten Tag bemerken, überspringen Sie die vergessene Dosis und nehmen Sie das Arzneimittel zur gewohnten Zeit weiter ein und kontaktieren Sie Ihren Arzt oder Ihre Ärztin.
Nehmen Sie niemals zwei Tagesdosen am selben Tag ein.
Bei Überdosierung von Marcoumar kann es zu Blutungen kommen. Informieren Sie sofort Ihren Arzt bzw. Ihre Ärztin. Bewusstlosigkeit kann ein Anzeichen für eine Gehirnblutung sein.
Unter Marcoumar sind Blutungen möglich, an denen verschiedene Organe beteiligt sein können und die lebensbedrohlich sein können.
Folgende Nebenwirkungen können bei der Einnahme oder Anwendung von Marcoumar auftreten:
Sehr häufige Nebenwirkungen: Blutergüsse nach Verletzungen, Nasenbluten, Zahnfleischbluten, Blut im Urin.
Gelegentliche Nebenwirkungen: Innere Blutungen, Blutungen im Bereich des Rückenmarks und Gehirns, Blutungen im Auge, Blutungen im Bereich von Gelenken oder Muskeln, brennende Schmerzen in den Grosszehen mit gleichzeitiger Verfärbung (Purple toes).
Seltene Nebenwirkungen: Blutmangel infolge der Blutungen, Erkrankungen des Verdauungstraktes, Haarausfall.
Sehr seltene Nebenwirkungen: Druckschädigung des Oberschenkelnervs infolge einer inneren Blutung, im Allgemeinen vorübergehende Leberentzündung mit oder ohne Gelbsucht, Leberversagen, Hautnekrosen (Absterben von Hautarealen). Im Falle einer Hautnekrose oder roten Flecken auf der Haut (Purpura fulminans) informieren Sie sofort Ihren Arzt oder Ihre Ärztin.
Nebenwirkungen mit unbekannter Häufigkeit: Allergische, entzündliche Hautreaktionen, Erbrechen, Durchfall, Übelkeit, Appetitverlust, Erkrankungen der Skelettmuskulatur, von Bindegewebe oder Knochen, Osteoporose (Knochenschwund) nach Langzeitbehandlung.
Wenn Sie Nebenwirkungen bemerken, die hier nicht beschrieben sind, sollten Sie Ihren Arzt oder Apotheker bzw. Ihre Ärztin oder Apothekerin informieren.
Das Arzneimittel darf nur bis zu dem auf der Packung mit «EXP» bezeichneten Datum verwendet werden.
Nicht über 30 °C lagern.
Ausser Reichweite von Kindern aufbewahren.
Weitere Auskünfte erteilt Ihnen Ihr Arzt oder Apotheker bzw. Ihre Ärztin oder Apothekerin. Diese Personen verfügen über die ausführliche Fachinformation.
1 Tablette (weiss) enthält als Wirkstoff 3 mg Phenprocoumon, Laktose und weitere Hilfsstoffe.
19395 (Swissmedic).
In Apotheken, gegen ärztliche Verschreibung, die nur zum einmaligen Bezug berechtigt.
Tabletten (Kreuzbruchrille) zu 3 mg: 25 und 100.
MEDA Pharma GmbH, 8602 Wangen-Brüttisellen.
Diese Packungsbeilage wurde im Oktober 2014 letztmals durch die Arzneimittelbehörde (Swissmedic) geprüft.
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