Acenocoumarol therapy in pediatric patients.
To determine guidelines for administering and monitoring acenocoumarol therapy in children, 93 patients (median 5.1 years, range: 0.2-18 years) were prospectively evaluated over a 33-month period. The loading doses used were: <1 year, 0.20 mg x kg-1; >1-5 years, 0.09 mg x kg-1; 6-10 years, 0.07 mg x kg-1; 11-18 years, 0.06 mg x kg-1. In this study, the loading dose and the dose to achieve and maintain target therapeutic range (TTR) for acenocoumarol are age-dependent, with infants having the highest and teenagers having the lowest requirements. The use of a different loading dose according to age has allowed most of the children (80%) in all the age groups to achieve TTR in less than 1 week. No patients had serious bleeding or thrombotic complications. We conclude that there is an age-dependent response to acenocoumarol in pediatric patients. The implementation of an age-adjusted loading dose regimen reduces the length of hospitalization required to achieve effective anticoagulant therapy.
Bonduel
M
M
Departamento de Haematología-Oncología, Hospital de Pediatría 'Prof Dr Juan P. Garrahan', Combate de los Pozos 1881, Buenos Aires, Argentina. mbonduel@garrahan.gov.ar
Sciuccati
G
G
Hepner
M
M
Torres
A Feliu
AF
Pieroni
G
G
Frontroth
J P
JP
Serviddio
R M
RM
D000074:Acenocoumarol / Q000008:administration & dosage* / Q000627:therapeutic use*; D000293:Adolescent; D000367:Age Factors; D000925:Anticoagulants / Q000008:administration & dosage* / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D013923:Thromboembolism / Q000188:drug therapy; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000188:drug therapy*
D000925:Anticoagulants; D000074:Acenocoumarol