Alcohol and Marcumar | Coumar®

Alcohol and Marcumar

With Marcumar® and alcohol, it is particularly important whether it is a one-off or occasional consumption of alcohol or a regular, very high consumption of alcohol. The effect of Marcumar® can be increased by rarely consuming alcohol. Injuries or falls, which are frequently associated with alcohol, become dangerous due to the increased risk of bleeding.

In contrast, the effect of Marcumar® is weakened by daily heavy alcohol consumption. In this case, the risk of blood clots forming is increased and thus the risk of heart attacks and strokes also increases. If a large amount of alcohol is drunk regularly over years, this can damage the liver.

The liver is an organ that is very important for many detoxification and breakdown processes. If it suffers severe damage, it can no longer perform this function properly. Since the liver is also important for the breakdown of Marcumar®, this is reduced by liver damage. For this reason, high alcohol consumption with liver damage results in an increased amount of Marcumar in the body and the anticoagulant effect of Marcumar is increased.

Alternatives

If drug inhibition of blood clotting is necessary, there are several alternatives to Marcumar. These include active ingredients that inhibit coagulation in the same way as Marcumar. They are all known as vitamin K antagonists.

The best known drugs are warfarin and acenocoumarol. The difference to Marcumar is that they work faster, but not as long. In some countries, such as the USA, these drugs are used more frequently than Marcumar.

Another alternative to Marcumar are the direct oral anticoagulants (DOAK). In contrast to Marcumar, they do not prevent the formation of coagulation factors but directly inhibit the tenth coagulation factor in particular. This factor is involved in a decisive part of the clotting process.

For this reason, these drugs are as effective as Marcumar. The group of direct oral anticoagulants includes, for example, rivaroxaban, apixaban and dabigatran. As an alternative to Marcumar, they have advantages and disadvantages, which is why it should be weighed up individually which drugs achieve the best result for the patient.

Since DOAKs act directly on the coagulation factor, their effect also occurs very quickly. With Marcumar, on the other hand, it takes about 48 hours before the effect is felt. Marcumar also influences many different factors and the effect is more difficult to estimate.

As a result, the coagulation function must often be controlled during therapy with Marcumar. On the one hand, this is more complicated, but on the other hand, the therapy can be monitored very closely. When DOAKs are taken, the effect can be better estimated and the monitoring effort is much lower.

Marcumar is broken down in the liver, whereas DOAKs are excreted via the kidneys. Therefore, if these organs are not functioning properly, the medication should be adjusted or changed. Recent studies have shown that Marcumar is more effective in treating heart valve disease and artificial valves. DOAKs are superior for many other reasons of anticoagulation.