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Pronounced: MIR-a-don
Generic name: Anisindione

Why is this drug prescribed: Miradon is a blood thinner (an anticoagulant). It is used to prevent and treat blood clots in the veins. It is also used in the prevention and treatment of pulmonary embolism (a clot lodged in an artery serving the lungs), and in the treatment of certain serious heart conditions. Miradon is prescribed only if you cannot take coumarin-type anticoagulants such as Coumadin.

Most important fact about this drug: Miradon is a powerful drug with serious potential side effects. The benefits of taking it must be weighed against the risks. The worst potential side effects of Miradon include severe bleeding (hemorrhage) and destruction of skin tissue (necrosis) or gangrene. In occasional cases, hemorrhage and necrosis have led to death or permanent disability. Severe necrosis can result in removal of damaged tissue or amputation of a limb. Necrosis usually occurs within a few days of starting Miradon therapy. If it develops, the doctor will have to switch to a different type of blood thinner.

How should you take this medication: The purpose of treatment with a blood thinner is to prevent abnormal clots from forming and cutting off the blood supply necessary for normal body function. To achieve this, treatment must maintain a delicate balance between too much clotting and too little, since a failure to clot could lead to uncontrolled bleeding and even death. It is very important, therefore, that you take this medication exactly as prescribed and that your doctor monitor your condition on a regular basis. Be especially careful to stick to the exact dosage schedule and to follow your doctor's directions for periodic blood tests. Effective treatment with minimal complications depends on your cooperation and communication with your doctor. Many foods and drugs can significantly change the effectiveness of Miradon, so check with the doctor before starting or discontinuing any other medication or making any change in your diet, and do not stop taking this medication suddenly. --If you miss a dose... Take it as soon as possible. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once. --Storage instructions... Store at room temperature.

What side effects may occur: Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Miradon. Side effects may include: Abdominal cramps, abnormal healing of broken bones, anemia, blood disorders, blurred vision, diarrhea, fever, greasy stools, hair loss, headache, hemorrhage, hepatitis, hives, inability to urinate, kidney damage, liver damage, loss of appetite, lung inflammation, minor bleeding, mouth or throat ulcers, nausea, necrosis (gangrene), prolonged, painful erection, paralyzed eye muscle, purple toes, rash, red or peeling skin, sore mouth, sore throat, vomiting, yellowed skin and whites of eyes

Why should this drug not be prescribed: You should not take Miradon if you have any condition that may increase the danger of hemorrhage, including: A bleeding disorder or a tendency to hemorrhage, such as hemophilia, bleeding under the skin, or leukemia A recent cerebral hemorrhage (bleeding stroke) Aneurysm (balloon-like swelling of a blood vessel) Bleeding, ulcers, or inflammation in the stomach or intestines Continuous tube drainage of the small intestine Eclampsia, a serious pregnancy disorder producing life-threatening convulsions, or preeclampsia, a toxic condition marked by high blood pressure that can lead to eclampsia Infection or inflammation of the heart Malnutrition or excessive loss of weight Open wounds Polyarthritis Recent or planned brain, eye, prostate, or spinal surgery Severe high blood pressure Severe kidney or liver disease Spinal puncture from regional or lumbar block anesthesia Threatened miscarriage Tumors Vitamin C or K deficiencies This drug can damage a developing baby and should not be used during pregnancy.

Special warnings about this medication: Treatment with blood thinners may increase the risk that part of a blood clot will break away from the wall of an artery and lodge in another point, causing a blockage of the blood vessel. Tell your doctor if you or anyone in your family has a history of blood clots moving and causing blockages. Notify your doctor immediately if you have any symptoms of abnormal bleeding, such as blood in urine; blood in stools or black, tarry stools; bleeding from gums or nose; patches of discoloration or bruises on the arms, legs, or toes; or excessive bleeding from minor cuts. Also tell the doctor about any other symptoms that may develop, such as fatigue, chills, or fever. If you are taking Miradon, your doctor should periodically check the time it takes for your blood to start the clotting process (prothrombin time). Carefully follow your doctor's directions for taking the periodic clotting test. Your doctor also should do periodic urine and stool tests to monitor the side effects of this drug. A number of things may affect your response to this drug, including your environment and your mental, medical, and nutritional state. Factors that may affect your sensitivity to this medication include hot weather, increased age, poor nutrition, vitamin K deficiency, intestinal disorders, high cholesterol levels, congestive heart failure or heart damage, diabetes, liver disorders, thyroid disorders, pregnancy, bowel sterilization, recent surgery, x-ray therapy, heredity, and the length of time you have been taking this medication.

Possible food and drug interactions when taking this medication: Starting or stopping any medication while taking Miradon may affect your body's response to the drug, requiring an adjustment in dosage. Check with your doctor before making any change in the drugs you take, whether prescription or nonprescription. Certain foods also affect your body's response to Miradon, so get your doctor's approval for any change in your typical diet while taking Miradon, and for any vitamins or nutritional supplements you'd like to take.

Special information if you are pregnant or breastfeeding: Miradon must not be taken during pregnancy because it may cause a fatal hemorrhage or birth defects in the developing baby. If you become pregnant while taking Miradon, inform your doctor immediately. Miradon appears in breast milk and could affect a nursing infant. Do not breastfeed while on Miradon therapy.

Recommended dosage: The usual doses at the start of therapy are 300 milligrams on the first day, 200 milligrams on the second day, and 100 milligrams on the third day. After the initial doses, you'll be maintained at a level of 25 to 250 milligrams a day. Your doctor will individualize the dosage of Miradon according to your sensitivity to the drug.

Overdosage: An overdose of Miradon is likely to cause abnormal bleeding. Symptoms of abnormal bleeding include: Bleeding from gums or nose, blood in urine or stools, excessive bleeding from minor cuts, patches of discoloration or bruises on the skin If you suspect an overdose of Miradon, seek emergency medical attention immediately.

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