What is Sintrom, what it is for, contraindicated foods and side effects

Hematologist Nuria Fernández works at the Miguel Servet Hospital and, therefore, works daily with patients who use Sintrom in their treatment. Sintrom belongs to the family of oral anticoagulants, and It is one of the best-selling medicines in Spain.

Dr. Fernández explains that anticoagulants “are collectively defined as 'antivitamin K', because the effect they have as a treatment is to interfere with the activation mechanism of coagulation factors., in which vitamin K participates. In anticoagulated people there is a reason: Their condition causes them to have a greater risk of forming blood clots.. In these cases, the anticoagulant makes the blood more liquid and, therefore, there is less predisposition to thrombi and clots, which can compromise your life."

What is Sintrom for and why can it get out of control?

The most common indication for treatment with Sintrom is atrial fibrillation arrhythmia. “Arrhythmia,” explains Fernández, “simply indicates that the heart does not have a constant and regular beat. The blood that must leave the heart with each beat is not the same in people who suffer from arrhythmia, and blood is retained inside the heart chambers; "That blood, due to its own characteristics, tends to form small clots."

There's others patients treated with Sintrom, usually younger, who have cardiac prostheses. “The organism defends itself and rejects this mechanical material in their valves, so the blood needs to be more liquid so that thrombi do not form around the affected valve. Other patients are those who must rest for a long time, or undergo surgery and require immobilization during their recovery; there thrombi may appear in the veins of the legs. If any of those thrombi break off and end up settling in the lung, for example, the treatment dissolves that small clot.”

The Sintrom, power and interference 

Sintrom has a very narrow therapeutic range. “It does not have a fixed dose, like most medications when treating all types of patients, making minimal adjustments due to age or weight. In the case of Sintrom, each patient needs an individual dose adjustment; The patient can take medications that compete with each other and cause the effect to increase or decrease.”

Are there foods prohibited if you take Sintrom?

As for food, There is a bit of urban legend about some contraindicated foods, such as green leafy vegetable or avocado. “In reality – explains the hematologist from Servet – Food can interfere with treatment if there is a sudden change in diet. A person who takes the Mediterranean diet and must start with Sintrom will simply have to adjust the dose according to what he eats, including vegetables, and not abuse those that can increase vitamin K. If that person suddenly becomes a vegetarian or vegan, you will consume much more vitamin K; somehow we would give the patient the Sintrom and he would take the antidote from it, a disaster. If you suffer from gastroenteritis, the effect may also vary. There must be controls with high frequency until the stable weekly dose is found.”

Medication control in everyday life

Control of the effectiveness of the medication begins with the patient himself. “They are made capillary controls on the fingers, like those for glucose, and the dose is adjusted based on the measurements. Little by little, visits to the doctor are extended: from one every two weeks to one monthly, or one every month and a half in the most stable patients. If there is any incident, the visit is brought forward, of course.”

Dr. Fernández expands the explanation with a very graphic example. “Many patients with healing problems are told not to shave with a razor and to use razors. This is not strictly the case, the correct thing would be to tell them to be very careful., use enough foam and shave calmly. The same thing happens with foods that have vitamin K among those who take Sintrom; calm, without abusing. What those treated with Sintrom should avoid are intramuscular injections, which will cause severe bruising, or herbal products that may contain St. John's wort or some seeds very rich in vitamin K, without being strictly specified in the composition; You have to be well informed about what is in everything you take, and consult your doctor if you have questions.

Side effects of Sintrom

The main one is that of any anticoagulant. “Any trauma or injury,” says Fernández, “involves more intense and lasting bleeding. Of course, there is no spontaneous bleeding from Sintrom. On the other hand, for the pregnant women It is contraindicated between weeks 6 and 12, because it can cause malformations in the fetus, especially in the bones of the face. Then it can be administered, but normally in those cases we apply a replacement anticoagulant, such as low molecular weight heparin; It is pricked and since it has a shorter duration of effect on the blood, it allows, for example, that at the time of delivery it be programmed so that there is less bleeding, and they can even have an epidural.

The Sintrom is not the same as the Adiro

Adiro, equally popular, also makes the blood more liquid, but its field of action is different. “It acts at the level of platelet function; In some cases it can even be associated with Sintrom, it does not replace it. “Adiro is an antiaggregant.” Sintrom, in fact, is not the only anticoagulant; Others have appeared in the last decade, but this is the most consumed.

All kinds of questions come to hematologists. “I have been asked if Sintrom affected hair dye or greater loss. There will always be adverse effects with any medication, but not those. Yes there can be what we call toxicodermia, in the form of pimples or mild wheals that are itchy and annoying. If they are intense, you can consider changing Sintrom for its cousin, Warfarin, from the same family of medications, with a change at the molecular level. It is more used in the United States or the United Kingdom, and does not cause these toxicoderma problems; Its effect on the blood also lasts longer.”