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Phenprocoumon
Also known as: 435-97-2, Phenprocoumarol, Phenprocoumarole, 4-hydroxy-3-(1-phenylpropyl)-2h-chromen-2-one, Liquamar, Marcumar
Molecular Formula
C18H16O3
Molecular Weight
280.3  g/mol
InChI Key
DQDAYGNAKTZFIW-UHFFFAOYSA-N
FDA UNII
Q08SIO485D

Coumarin derivative that acts as a long acting oral anticoagulant.
Phenprocoumon is a Vitamin K Antagonist. The mechanism of action of phenprocoumon is as a Vitamin K Inhibitor.
1 2D Structure

Phenprocoumon

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
4-hydroxy-3-(1-phenylpropyl)chromen-2-one
2.1.2 InChI
InChI=1S/C18H16O3/c1-2-13(12-8-4-3-5-9-12)16-17(19)14-10-6-7-11-15(14)21-18(16)20/h3-11,13,19H,2H2,1H3
2.1.3 InChI Key
DQDAYGNAKTZFIW-UHFFFAOYSA-N
2.1.4 Canonical SMILES
CCC(C1=CC=CC=C1)C2=C(C3=CC=CC=C3OC2=O)O
2.2 Other Identifiers
2.2.1 UNII
Q08SIO485D
2.3 Synonyms
2.3.1 MeSH Synonyms

1. Falithrom

2. Liquamar

3. Marcoumar

4. Marcumar

5. Phenprocoumalol

6. Phenprocoumarol

7. Phenprogramma

8. Phenylpropylhydroxycumarinum

2.3.2 Depositor-Supplied Synonyms

1. 435-97-2

2. Phenprocoumarol

3. Phenprocoumarole

4. 4-hydroxy-3-(1-phenylpropyl)-2h-chromen-2-one

5. Liquamar

6. Marcumar

7. Fencumar

8. Marcoumar

9. Falithrom

10. Phenprocumone

11. Phenprocoumone

12. Fenprocumone

13. Phenprocoumonum

14. Fenprocumone [dcit]

15. 3-(1-phenylpropyl)-4-hydroxycoumarin

16. 4-hydroxy-3-(1-phenylpropyl)-2h-1-benzopyran-2-one

17. 3-(1'-phenyl-propyl)-4-oxycoumarin

18. Ro 1-4849

19. 3-(alpha-ethylbenzyl)-4-hydroxycoumarin

20. 3-(alpha-phenylpropyl)-4-hydroxycoumarin

21. 2h-1-benzopyran-2-one, 4-hydroxy-3-(1-phenylpropyl)-

22. 4-hydroxy-3-(1-phenylpropyl)chromen-2-one

23. Phenprocumonum

24. Chembl16694

25. Q08sio485d

26. Chebi:50438

27. Bs-7565

28. Fenprocoumona

29. 3-(.alpha.-ethylbenzyl)-4-hydroxycoumarin

30. Ro-1-4849

31. Coumarin, 3-(.alpha.-ethylbenzyl)-4-hydroxy-

32. 2-hydroxy-3-(1-phenylpropyl)-4h-chromen-4-one

33. Fenprocoumona [inn-spanish]

34. Phenprocoumone [inn-french]

35. Phenprocoumonum [inn-latin]

36. Fenprocumon

37. Liquamar (tn)

38. Hsdb 3248

39. Einecs 207-108-9

40. 3-(1'-phenyl-propyl)-4-oxycoumarin [german]

41. Phenprocoumon (usan/inn)

42. Brn 1291115

43. Unii-q08sio485d

44. Coumarin, 3-(alpha-ethylbenzyl)-4-hydroxy-

45. Phenprocoumon [usan:usp:inn:ban]

46. Phenprocoumon (marcumar)

47. Phenprocoumon [mi]

48. Phenprocoumon [inn]

49. U29342

50. Chembl1465

51. Phenprocoumon [hsdb]

52. Phenprocoumon [usan]

53. Oprea1_002598

54. Schembl43031

55. Bdbm768

56. Phenprocoumon [vandf]

57. Mls006010940

58. Phenprocoumon [mart.]

59. (+/-)-phenprocoumon

60. Phenprocoumon [who-dd]

61. Gtpl6839

62. Schembl1651720

63. Dtxsid5023459

64. Phenprocoumon [orange Book]

65. Bcp01576

66. Hy-a0145

67. S2188

68. 3-(a-ethyl-benzyl)-4-hydroxycoumarin

69. Akos002126557

70. Akos016844146

71. Db00946

72. Ncgc00346442-02

73. 70206-44-9

74. As-77043

75. Smr004703040

76. Cs-0017467

77. Ft-0698417

78. Phenprocoumon 100 Microg/ml In Acetonitrile

79. D05457

80. D82043

81. 4-hydroxy-3-(1-phenylpropyl)-2h-chromen-2-on

82. 435-97-2,53621-47-9 (sodium Salt)

83. Q267896

84. 3-(.alpha.-phenylpropyl)-4-hydroxycoumarin

85. 4-hydroxy-3-(1-phenylpropyl)-2h-chromen-2-one #

86. J-510448

87. Dl-3-(.alpha.-ethylbenzyl)-4-hydroxycoumarin

88. 4-hydroxy-2-oxo-3-(1-phenylpropyl)-2h-chromene

89. Z2186911943

90. 2h-pyran-2-one, 4-hydroxy-3-[[2-(1-methylethyl)phenyl]thio]-6-(3-methylphenyl)-

91. 3-(1-phenylpropyl)-4-hydroxycoumarin; 4-hydroxy-2-oxo-3-(1-phenylpropyl)-2h-chromene

92. 5999-41-7

2.4 Create Date
2011-12-26
3 Chemical and Physical Properties
Molecular Weight 280.3 g/mol
Molecular Formula C18H16O3
XLogP33.6
Hydrogen Bond Donor Count1
Hydrogen Bond Acceptor Count3
Rotatable Bond Count3
Exact Mass280.109944368 g/mol
Monoisotopic Mass280.109944368 g/mol
Topological Polar Surface Area46.5 Ų
Heavy Atom Count21
Formal Charge0
Complexity420
Isotope Atom Count0
Defined Atom Stereocenter Count0
Undefined Atom Stereocenter Count1
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Therapeutic Uses

Anticoagulants

National Library of Medicine's Medical Subject Headings online file (MeSH, 1999)


A prothrombopenic anticoagulant with actions and uses similar to those of dicumarol. Its onset of action is 48-72 hr, and its duration of action may be as long as 7 days. ...

Osol, A. and J.E. Hoover, et al. (eds.). Remington's Pharmaceutical Sciences. 15th ed. Easton, Pennsylvania: Mack Publishing Co., 1975., p. 764


Anticoagulants are indicated in the treatment of patients with recent deep vein thrombosis or thrombophlebitis to prevent extension and embolization of the thrombus and to reduce the risk of pulmonary embolism or recurrent thrombus formation. In acute pulmonary embolism or venous thrombosis, anticoagulants are indicated following initial thrombolytic and/or heparin therapy to decrease the risk of extension, recurrence, or death. /Anticoagulants/

MICROMEDEX Thomson Health Care. USPDI - Drug Information for the Health Care Professional. 22nd ed. Volume 1. MICROMEDEX Thomson Health Care, Greenwood Village, CO. 2002. Content Reviewed and Approved by the U.S. Pharmacopeial Convention, Inc., p. 265


Anticoagulants may prevent the formation of mural thrombi in the heart, which may lead to systemic thromboembolism in patients with chronic atrial fibrillation, especially those with rheumatic mitral stenosis, prosthetic heart valves, left atrial enlargement, or cardiomyopathy. In these patients, anticoagulants may decrease the risk of arterial embolism, pulmonary embolism, or subsequent stroke. /Anticoagulants/

MICROMEDEX Thomson Health Care. USPDI - Drug Information for the Health Care Professional. 22nd ed. Volume 1. MICROMEDEX Thomson Health Care, Greenwood Village, CO. 2002. Content Reviewed and Approved by the U.S. Pharmacopeial Convention, Inc., p. 266


For more Therapeutic Uses (Complete) data for PHENPROCOUMON (8 total), please visit the HSDB record page.


4.2 Drug Warning

Contraindications to oral anticoagulants include pre-existing or coexisting abnormalities of blood coagulation, active bleeding, recent or imminent surgery of the central nervous system or eye, diagnostic or therapeutic procedures with potential for uncontrollable bleeding including lumbar puncture, malignant hypertension, peptic ulceration, pregnancy, threatened abortion, intrauterine device, cerebrovascular hemorrhage, and bacterial endocarditis. Relative contraindications include thrombocytopenia, pericarditis, pericardial effusions, and unreliability of the patient or of patient supervision. /Oral anticoagulants/

Haddad, L.M., Clinical Management of Poisoning and Drug Overdose. 2nd ed. Philadelphia, PA: W.B. Saunders Co., 1990., p. 308


Most commonly, oral anticoagulant-induced bleeding is minor and consists of bruising, hematuria, epistaxis, conjunctival hemorrhage, minor gastrointestinal bleeding, bleeding from wounds and sites of trauma, and vaginal bleeding. More serious major or fatal bleeding is most commonly gastrointestinal, intracranial, vaginal, retroperitoneal, or related to a wound or site of trauma, although a large variety of other sites of bleeding have been reported. Intracranial bleeding occurs most frequently in patients receiving oral anticoagulants for cerebrovascular disease and most commonly presents as a subdural hematoma, often unassociated with head trauma. Fatal gastrointestinal bleeding is most commonly from a peptic ulcer, although any gastrointestinal lesion may be a potential source of major bleeding. Overall, a bleeding lesion can be identified in about two thirds of cases of oral anticoagulants-related hemorrhage. /Oral anticoagulants/

Haddad, L.M., Clinical Management of Poisoning and Drug Overdose. 2nd ed. Philadelphia, PA: W.B. Saunders Co., 1990., p. 311


Overall, the bleeding rate of oral anticoagulant therapy is influenced by several factors: the intensity of anticoagulation, either intentionally or inadvertent; the underlying clinical disorder for which anticoagulant therapy is used (with bleeding occurring most frequently in ischemic cerebrovascular disease and venous thromboembolism; and, with bleeding occurring most commonly in the elderly; the presence of adverse drug interactions or comorbid factors such as clinical states potentiating warfarin action, pre-existing hemorrhagic diathesis, malignancy, recent surgery, trauma, or pre-existing potential bleeding sites (e.g., surgical wound, peptic ulcer, recent cerebral hemorrhage, carcinoma of colon); the simultaneous use of aspirin (but not of dipyridamole); and patient reliability (e.g., increased bleeding in alcoholics not due to ethanol-warfarin drug interaction but rather to unreliability of drug intake). /Oral anticoagulants/

Haddad, L.M., Clinical Management of Poisoning and Drug Overdose. 2nd ed. Philadelphia, PA: W.B. Saunders Co., 1990., p. 310


It is inadvisable to carry out long-term therapy in chronic alcoholic, in individual who may require intensive salicylate therapy, or in cases of malignant hypertension and active tuberculosis. Oral anticoagulant therapy during pregnancy carries significant hemorrhagic risk for fetus. /oral anticoagulants/

Goodman, L.S., and A. Gilman. (eds.) The Pharmacological Basis of Therapeutics. 5th ed. New York: Macmillan Publishing Co., Inc., 1975., p. 1360


For more Drug Warnings (Complete) data for PHENPROCOUMON (21 total), please visit the HSDB record page.


4.3 Drug Indication

Used for the prevention and treatment of thromboembolic disease including venous thrombosis, thromboembolism, and pulmonary embolism as well as for the prevention of ischemic stroke in patients with atrial fibrillation (AF).


5 Pharmacology and Biochemistry
5.1 Pharmacology

Phenprocoumon, a coumarin anticoagulant, thins the blood by antagonizing vitamin K which is required for the production of clotting factors in the liver. Anticoagulants such as phenprocoumon have no direct effect on an established thrombus, nor do they reverse ischemic tissue damage (damage caused by an inadequate blood supply to an organ or part of the body). However, once a thrombus has occurred, the goal of anticoagulant treatment is to prevent further extension of the formed clot and prevent secondary thromboembolic complications which may result in serious and possibly fatal sequelae.


5.2 MeSH Pharmacological Classification

Anticoagulants

Agents that prevent BLOOD CLOTTING. (See all compounds classified as Anticoagulants.)


5.3 FDA Pharmacological Classification
5.3.1 Active Moiety
PHENPROCOUMON
5.3.2 FDA UNII
Q08SIO485D
5.3.3 Pharmacological Classes
Mechanisms of Action [MoA] - Vitamin K Inhibitors
5.4 ATC Code

B01AA04

S76 | LUXPHARMA | Pharmaceuticals Marketed in Luxembourg | Pharmaceuticals marketed in Luxembourg, as published by d'Gesondheetskeess (CNS, la caisse nationale de sante, www.cns.lu), mapped by name to structures using CompTox by R. Singh et al. (in prep.). List downloaded from https://cns.public.lu/en/legislations/textes-coordonnes/liste-med-comm.html. Dataset DOI:10.5281/zenodo.4587355


B - Blood and blood forming organs

B01 - Antithrombotic agents

B01A - Antithrombotic agents

B01AA - Vitamin k antagonists

B01AA04 - Phenprocoumon


5.5 Absorption, Distribution and Excretion

Absorption

Bioavailability is close to 100%


Coumarin anticoagulants pass placental barrier. /coumarin anticoagulants/

Goodman, L.S., and A. Gilman. (eds.) The Pharmacological Basis of Therapeutics. 5th ed. New York: Macmillan Publishing Co., Inc., 1975., p. 1359


The disposition of phenprocoumon differed between male and female rats, with a substantially lower apparent volume of distribution and clearance in female rats. Although female rats had a lower sensitivity to the drug, the differences in kinetics caused an apparent equal response to the same doses and a longer duration of effect.

PMID:2901471 Trenk D et al; J Pharm Pharmacol 40: 403-7 (1988)


Samples of urine and feces were collected daily from a normal human volunteer who had received a dose of pseudoracemic phenprocoumon ...containing a tracer dose of 10 microCi of (14C)phenprocoumon... . After 25 days, 96% of the radiolabeled material was recovered (62.8% in urine and 33.3% in feces). ...The urinary excretion pattern was also confirmed in four additional healthy male subjects who received a single oral dose of pseudoracemic phenprocoumon... . All the drug-related materials (both hydroxylated metabolites and parent compound) that were excreted into the urine were extensively conjugated.

PMID:4078699 Toon S et al; J Pharm Sci 74 (10): 1037-40 (1985)


...A study was conducted in 24 healthy volunteers, ages 23-28 yr, who received an oral and an IV dose of phenprocoumon 9 mg at 3 wk intervals. The following mean data were obtained after IV injection: half-life alpha 0.432 hr, half-life beta 128 hr, initial blood level 0.651 ug/ml, volume of distribution 14.41, area under the concn curve (AUC) 121 ugxhr/ml. After oral intake the following mean values were measured: Tmax 2.25 hr, Cmax 1.01 ug/ml, absorption half-life 0.553 hr, initial blood level 0.865 ug/ml, half-life beta 132 hr, AUC 164 ugxhr/ml. A total mean clearance of 20.0 (IV) and 15.1 (oral) ml/hr was calculated within the first 8 hr post dose, while values measured did not differ between 8 and 48 hr post dose. ...

PMID:8032579 Haustein KO, Huller G; Int. J. Clin. Pharmacol. Ther. 32: 192-197 (1994)


5.6 Metabolism/Metabolites

Phenprocoumon is stereoselectively metabolized by hepatic microsomal enzymes (cytochrome P-450) to inactive hydroxylated metabolites (predominant route) and by reductases to reduced metabolites. Cytochrome P450 2C9 is the principal form of human liver P-450 responsible for metabolism.


Pooled plasma from patients receiving phenprocoumon anticoagulant therapy was extracted and the following substances were characterized: phenprocoumon, and its 7-hydroxy,4'-hydroxy and 6-hydroxy derivatives; they were identified by HPLC and after methylation by quartz capillary GC-MS using the electron impact and selective ion monitoring modes. This is the first occasion when phenprocoumon metabolites have been identified in plasma; they were unconjugated and in much lower concentrations (43.2 and 2 ng/ml for the 7,4' and 6-hydroxy derivatives, respectively) than the original compound (2000 ng/ml).

de Vries J; Eur J Clin Pharmacol 29(5): p 591-4 (1986)


...The metabolites of /pseudoracemic phenprocoumon/ were identified as the 4'-, 6-, and 7-hydroxy analogues of phenprocoumon. Virtually all of the recovered radioactivity could be accounted for by the parent drug (approximately 40%) and the three metabolites (approximately 60%). The formation of both 4'-(8.1% of administered dose) and 7- (33.4% of administered dose) hydroxyphenprocoumon was highly stereoselective, giving S/R ratios of 2.86 and 1.69, respectively. The formation of 6- (15.5% of administered dose) hydroxyphenprocoumon showed little stereoselectivity (S/R ratio equal to 0.85).

PMID:4078699 Toon S et al; J Pharm Sci 74 (10): 1037-40 (1985)


5.7 Biological Half-Life

5-6 days


Phenprocoumon (Marcumar) has a longer plasma half-life /of/ 5 days than warfarin, as well as a somewhat slower onset of action and a longer duration of action (7-14 days).

Hardman, J.G., L.E. Limbird, P.B., A.G. Gilman. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 10th ed. New York, NY: McGraw-Hill, 2001., p. 1531


Phenprocoumon was given orally to 9 patients with biopsy proven liver cirrhosis (dose range 0.12-0.25 mg/kg) and to 7 healthy volunteers (0.23 mg/kg). Concentrations of phenprocoumon were determined using HPLC in plasma and urine samples obtained for 6-7 days after drug administration. The binding of [3H]-phenprocoumon in plasma from all subjects was determined by equilibrium dialysis. Antipyrine plasma concentrations were determined spectrophotometrically following oral administration of antipyrine (1200 mg). The total body clearance of phenprocoumon was higher in the cirrhotic patients (1.64 +/- 0.16 ml/h/kg mean +/- SEM) than in the healthy volunteers (0.90 +/- 0.07 ml/h/kg), however the free drug clearance was not significantly different in the patients (144 +/- 14 ml/h/kg) compared with normal (113 +/- 11 ml/h/kg). In contrast the clearance of antipyrine was much reduced in the cirrhotic group (17.5 +/- 2.9 ml/h/kg) compared with normal (35.6 +/- 3.9 ml/h/kg). The metabolic clearance of phenprocoumon via glucuronidation, is relatively unaffected during cirrhosis compared with antipyrine clearance via oxidation.

Kitteringham N, et al; Eur J Clin Pharmacol 26(1): p 65-70 (1984)


...The following mean data were obtained after IV injection /of phenprocoumon/: half-life alpha 0.432 hr, half-life beta 128 hr... . After oral intake the following mean values were measured: ...absorption half-life 0.553 hr, ...half-life beta 132 hr... .

PMID:8032579 Haustein KO, Huller G; Int. J. Clin. Pharmacol. Ther. 32: 192-197 (1994)


5.8 Mechanism of Action

Phenprocoumon inhibits vitamin K reductase, resulting in depletion of the reduced form of vitamin K (vitamin KH2). As vitamin K is a cofactor for the carboxylation of glutamate residues on the N-terminal regions of vitamin K-dependent proteins, this limits the gamma-carboxylation and subsequent activation of the vitamin K-dependent coagulant proteins. The synthesis of vitamin K-dependent coagulation factors II, VII, IX, and X and anticoagulant proteins C and S is inhibited. Depression of three of the four vitamin K-dependent coagulation factors (factors II, VII, and X) results in decreased prothrombin levels and a decrease in the amount of thrombin generated and bound to fibrin. This reduces the thrombogenicity of clots.


The oral anticoagulants block the regeneration of reduced vitamin K and thereby induce a state of functional vitamin K deficiency. The mechanism of the inhibition of reductase(s) by the coumarin drugs is not known. There exist reductases that are less sensitive to these drugs but that act only at relatively high concentrations of oxidized vitamin K; this property may explain the observation that administration of sufficient vitamin K can counteract even large doses of oral anticoagulants. /Oral Anticoagulants/

Hardman, J.G., L.E. Limbird, P.B., A.G. Gilman. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 10th ed. New York, NY: McGraw-Hill, 2001., p. 1527


The disposition of a single intravenous bolus dose of 10 mg vitamin K1 and vitamin K1-2,3-epoxide were studied in two healthy subjects without and with 12 hr pretreatment dose of phenprocoumon (0.4 mg/kg). For each compound administered alone the plasma concn-time profile was adequately fitted by a biexponential equation, with an avg terminal half-life of 2.0 and 1.15 hr for the administered vitamin K and its 2,3-epoxide respectively. While vitamin K1 was measurable in plasma following admin of vitamin K1-2,3-epoxide, the epoxide was not detectable following admin of vitamin K1. Following pretreatment with phenprocoumon and after iv admin of vitamin K1, both the avg half-life and area under the plasma concn-time profile of vitamin K1 were marginally reduced to 1.5 hr and 1.76 mg/l/hr respectively, while the plasma concn of vitamin K1-2,3-epoxide was readily measurable and its half-life markedly prolonged to 14.7 hr. Following pretreatment with phenprocoumon and after oral administration of vitamin K1-2,3-epoxide, no vitamin K1 was detectable in plasma and the half-life of the epoxide was 13.8 hr. Based on area considerations the data suggest that either phenprocoumon does more than just inhibit the reduction of vitamin K1-2,3-epoxide to vitamin K1, or that the simple model describing the interconversion between vitamin K1 and its epoxide is inadequate. The same conclusion is drawn from the analysis of comparable data in dogs... .

PMID:6661354 Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1428333 Bechtold H, et al; Br J Clin Pharmacol 16 (6): 683-9 (1983)


Both 4-hydroxycoumarin derivatives and indandiones (also known as oral anticoagulants) are antagonists of vitamin K. Their use as rodenticides is based on the inhibition of the vitamin K-dependent step in the synthesis of a number of blood coagulation factors. The vitamin K-dependent proteins ...in the coagulation cascade... are the procoagulant factors II (prothrombin), VII (proconvertin), IX (Christmas factor) and X (Stuart-Prower factor), and the coagulation-inhibiting proteins C and S. All these proteins are synthesized in the liver. Before they are released into the circulation the various precursor proteins undergo substantial (intracellular) post-translational modification. Vitamin K functions as a co-enzyme in one of these modifications, namely the carboxylation at well-defined positions of 10-12 glutamate residues into gamma-carboxyglutamate (Gla). The presence of these Gla residues is essential for the procoagulant activity of the various coagulations factors. Vitamin K hydroquinone (KH2) is the active co-enzyme, and its oxidation to vitamin K 2,3-epoxide (KO) provides the energy required for the carboxylation reaction. The epoxide is than recycled in two reduction steps mediated by the enzyme KO reductase... . The latter enzyme is the target enzyme for coumarin anticoagulants. Their blocking of the KO reductase leads to a rapid exhaustion of the supply of KH2, and thus to an effective prevention of the formation of Gla residues. This leads to an accumulation of non-carboxylated coagulation factor precursors in the liver. In some cases these precursors are processed further without being carboxylated, and (depending on the species) may appear in the circulation. At that stage the under-carboxylated proteins are designated as descarboxy coagulation factors. Normal coagulation factors circulate in the form of zymogens, which can only participate in the coagulation cascade after being activated by limited proteolytic degradation. Descarboxy coagulation factors have no procoagulant activity (i.e. they cannot be activated) and neither they can be converted into the active zymogens by vitamin K action. Whereas in anticoagulated humans high levels of circulating descarboxy coagulation factors are detectable, these levels are negligible in warfarin-treated rats and mice. /Anticoagulant rodenticides/

WHO; Environ Health Criteria 175: Anticoagulant Rodenticides p.46 (1995)


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