Anticoagulant

Acenocoumarol and phenprocoumon

The coumarins much of Europe uses where warfarin is used elsewhere. Same mechanism, same genes, one level of evidence below — because the studies are smaller, not because the biology differs.

What this drug connects to

The genes involved

CYP2C9

Warfarin Sensitivity and Anticoagulant Dose Variability →

These are the other coumarin anticoagulants — acenocoumarol and phenprocoumon are used across much of Europe where warfarin is used elsewhere — and they block the same enzyme by the same mechanism. The genes that matter for warfarin therefore bear on them too: CYP2C9 clears them, and CYP4F2 changes how much vitamin K there is for the enzyme to act on. CPIC rates both pairs level B, one below warfarin, because the studies behind them are smaller rather than because the biology is different. The Dutch pharmacogenetics working group does publish dosing advice for them, which is worth knowing if you are reading a European report. Dose here is set by measuring clotting, whatever the genotype says.

CPIC lists CYP2C9–acenocoumarol and CYP4F2–acenocoumarol and CYP4F2–phenprocoumon at level B; no CPIC guideline has been published for them. Dutch Pharmacogenetics Working Group recommendations exist for both drugs.

Variants MyGeneLog™ reports for these genes

These are the positions in your own file that carry the genes above. Not every gene in a guideline is one we report — where that is the case the gene appears above without a variant here, and the note says so.

Omega-3 Fatty Acids to Polyunsaturated Fatty Acids percentage

CYP2C9 · rs9332238

Urine X-24354 levels in chronic kidney disease

CYP2C9 · rs111667734

Omega-3 fatty acid levels

CYP2C9 · rs55891451

X-11787 levels

CYP2C9 · rs9332172

Warfarin maintenance dose

CYP2C9 · rs4918798

X-11787 levels

CYP2C9 · rs1934963

X-21849 levels

CYP2C9 · rs9332217

X-17654 levels

CYP2C9 · rs1934969

Appendicular lean mass

CYP2C9 · rs28371678

Questions about Acenocoumarol and phenprocoumon

What are acenocoumarol and phenprocoumon?

Acenocoumarol and phenprocoumon are coumarin anticoagulants used across much of Europe where warfarin is used elsewhere. They block the same enzyme by the same mechanism as warfarin, so the same genes bear on them.

Do the same CYP2C9 and CYP4F2 variants that affect warfarin also affect acenocoumarol and phenprocoumon?

Yes. CYP2C9 clears acenocoumarol and phenprocoumon, and CYP4F2 changes how much vitamin K is available for the enzyme to act on — the same genes that matter for warfarin, because the drugs share a mechanism.

Is the evidence for CYP2C9 and acenocoumarol as strong as for warfarin?

No, one level below. CPIC rates both pairs level B, one below warfarin, because the studies behind them are smaller, not because the biology is different.

Is there dosing guidance for acenocoumarol and phenprocoumon based on genotype?

The Dutch pharmacogenetics working group publishes dosing advice for both drugs, worth knowing if you’re reading a European report — but as with warfarin, dose is set by measuring clotting, whatever the genotype says.

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Acenocoumarol and phenprocoumon. MyGeneLog™. https://www.mygenelog.com/drugs/coumarin-anticoagulants

This page is educational and contains no dosing information. Where a clinical guideline covers one of these gene-drug pairs it is written for prescribers and works through validated algorithms alongside clinical monitoring. Nothing here is a reason to start, stop, or change a medication — that conversation belongs with the clinician or pharmacist managing your treatment.