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2D Structure
Also known as: Dicoumarol, 66-76-2, Bishydroxycoumarin, Dicoumarin, Melitoxin, Bis-hydroxycoumarin
Molecular Formula
C19H12O6
Molecular Weight
336.3  g/mol
InChI Key
DOBMPNYZJYQDGZ-UHFFFAOYSA-N
FDA UNII
7QID3E7BG7

An oral anticoagulant that interferes with the metabolism of vitamin K. It is also used in biochemical experiments as an inhibitor of reductases.
1 2D Structure

2D Structure

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
4-hydroxy-3-[(4-hydroxy-2-oxochromen-3-yl)methyl]chromen-2-one
2.1.2 InChI
InChI=1S/C19H12O6/c20-16-10-5-1-3-7-14(10)24-18(22)12(16)9-13-17(21)11-6-2-4-8-15(11)25-19(13)23/h1-8,20-21H,9H2
2.1.3 InChI Key
DOBMPNYZJYQDGZ-UHFFFAOYSA-N
2.1.4 Canonical SMILES
C1=CC=C2C(=C1)C(=C(C(=O)O2)CC3=C(C4=CC=CC=C4OC3=O)O)O
2.2 Other Identifiers
2.2.1 UNII
7QID3E7BG7
2.3 Synonyms
2.3.1 MeSH Synonyms

1. Bishydroxycoumarin

2. Dicoumarin

3. Dicoumarol

2.3.2 Depositor-Supplied Synonyms

1. Dicoumarol

2. 66-76-2

3. Bishydroxycoumarin

4. Dicoumarin

5. Melitoxin

6. Bis-hydroxycoumarin

7. Antitrombosin

8. Baracoumin

9. Dicoumal

10. Dicumarine

11. Acadyl

12. Acavyl

13. Dicuman

14. Dicumol

15. Trombosan

16. Dufalone

17. Kumoran

18. Temparin

19. Cumid

20. Cuma

21. Dicumaol R

22. Dicoumarolum

23. 3,3'-methylenebis(4-hydroxycoumarin)

24. Bis(4-hydroxycoumarin-3-yl)methane

25. Bis-3,3'-(4-hydroxycoumarinyl)methane

26. Di-(4-hydroxy-3-coumarinyl)methane

27. Dicumarol [usan]

28. Di-4-hydroxy-3,3'-methylenedicoumarin

29. 3,3'-methylen-bis(4-hydroxy-cumarin)

30. 3,3'-methylenebis(4-hydroxy-2h-1-benzopyran-2-one)

31. 3,3'-methylene-bis(4-hydroxycoumarine)

32. 3,3'-methylenebis(4-hydroxy-1,2-benzopyrone)

33. 3,3'-methylenebis(4-hydroxy-2h-chromen-2-one)

34. Nc 034

35. 2h-1-benzopyran-2-one, 3,3'-methylenebis[4-hydroxy-

36. 3,3'-metilen-bis(4-idrossi-cumarina)

37. 3,3'-methyleen-bis(4-hydroxy-cumarine)

38. 3,3'-methanediylbis(4-hydroxy-2h-chromen-2-one)

39. Nsc 17860

40. Dicoumarol (inn)

41. Dicoumarol [inn]

42. 3,3'-methylenebis[4-hydroxycoumarin]

43. Dicumarol (usan)

44. Nsc 221570

45. 3,3'-methylene-bis(4-hydroxycoumarin)

46. 4-hydroxy-3-[(4-hydroxy-2-oxochromen-3-yl)methyl]chromen-2-one

47. Coumarin, 3,3'-methylenebis(4-hydroxy-

48. Nsc-17860

49. 7qid3e7bg7

50. Chembl1466

51. 2h-1-benzopyran-2-one), 3,3'-methylenebis(4-hydroxy-

52. Chebi:4513

53. Anathrombase

54. Apekumarol

55. Dicoumerol

56. Dicumarinum

57. Dicumarolum

58. 4-hydroxy-3-[(4-hydroxy-2-oxo-2h-chromen-3-yl)methyl]-2h-chromen-2-one

59. Nsc17860

60. Nsc41834

61. 3,2-benzopyrone]

62. Nsc-221570

63. Cas-66-76-2

64. Dicumarolo [dcit]

65. Ncgc00016296-01

66. Dwukumarol [polish]

67. Dicumarolo

68. Dikumarol

69. Dwukumarol

70. Dsstox_cid_1729

71. 3,3'-methylenebis[4-hydroxy-1,2-benzopyrone]

72. Dsstox_rid_76296

73. Dicumarol [inn-spanish]

74. Dsstox_gsid_21729

75. Dicoumarolum [inn-latin]

76. Chembl43154

77. 3,3'-methylenebis[4-hydroxy-2h-1-benzopyran-2-one]

78. 2h-1-benzopyran-2-one, 3,3'-methylenebis(4-hydroxy-

79. Coumarin,3'-methylenebis[4-hydroxy-

80. Dicumarol (tn)

81. Ccris 3713

82. Bis-3,3'-(4-oxycoumarinyl)ethylacetate

83. Nsc221570

84. Hsdb 3223

85. Wln: T66 Bovj Eq D1- Dt66 Bovj Eq

86. Sr-05000001605

87. 4,4'-dihydroxy-3,3'-methylene Bis Coumarin

88. Dicumarol [usan:usp]

89. 2h-1-benzopyran-2-one,3'-methylenebis[4-hydroxy-

90. Einecs 200-632-9

91. Nsc 41834

92. 2h-1-benzopyran-2-one],3'-methylenebis[4-hydroxy-

93. 3,3'-methylen-bis(4-hydroxy-cumarin) [german]

94. 3,3'-methyleen-bis(4-hydroxy-cumarine) [dutch]

95. 3,3'-methylene-bis(4-hydroxycoumarine) [french]

96. 3,3'-metilen-bis(4-idrossi-cumarina) [italian]

97. Unii-7qid3e7bg7

98. Brn 0335444

99. Ai3-14546

100. 4-hydroxy-3-((4-hydroxy-2-oxo-2h-chromen-3-yl)methyl)-2h-chromen-2-one

101. Symmetric Dicoumarol Analogue, 1

102. Uncoupler Of Oxidative Respiration

103. Prestwick_90

104. Mfcd00006857

105. Ethylm-trifluoromethylcarbanilate

106. Spectrum_000165

107. Dicumarol [mi]

108. Dicumarol [hsdb]

109. Prestwick0_000785

110. Prestwick1_000785

111. Prestwick2_000785

112. Prestwick3_000785

113. Spectrum2_000144

114. Spectrum3_000387

115. Spectrum4_000508

116. Spectrum5_000871

117. Dicumarol [vandf]

118. M0216

119. Chemdiv2_003436

120. Dicoumarol [mart.]

121. Dicoumarol [who-dd]

122. Dicoumarol [who-ip]

123. Oprea1_150990

124. Schembl33891

125. Schembl33892

126. Bspbio_000890

127. Bspbio_002173

128. Cbdive_003005

129. Kbiogr_001055

130. Kbioss_000645

131. 5-19-06-00682 (beilstein Handbook Reference)

132. Divk1c_000896

133. Spectrum1500239

134. Spbio_000248

135. Spbio_002829

136. Bpbio1_000980

137. Gtpl6808

138. Dicumarol [orange Book]

139. Dtxsid8021729

140. Bdbm35525

141. Hms502m18

142. Kbio1_000896

143. Kbio2_000645

144. Kbio2_003213

145. Kbio2_005781

146. Kbio3_001393

147. Dicoumarol - Cas 66-76-2

148. Ninds_000896

149. Hms1378m04

150. Hms1570m12

151. Hms1920e20

152. Hms2091m10

153. Hms2097m12

154. Hms3652p10

155. Hms3714m12

156. Hms3744m19

157. Hms3865f03

158. Pharmakon1600-01500239

159. Dicoumarolum [who-ip Latin]

160. Hy-n0645

161. Zinc3869855

162. Tox21_110357

163. 3,3'-methylenbis(4-hydroxycumarin)

164. 3,3-methylenebis(4-hydroxycoumarin)

165. Bbl008904

166. Ccg-34550

167. Nsc756733

168. S4299

169. Stk801287

170. Akos000520650

171. Tox21_110357_1

172. Am10016

173. Cs-7962

174. Db00266

175. Nsc-756733

176. Idi1_000896

177. Ncgc00016296-02

178. Ncgc00016296-03

179. Ncgc00016296-04

180. Ncgc00016296-05

181. Ncgc00016296-07

182. Ncgc00094650-01

183. Ncgc00094650-02

184. As-19619

185. Sbi-0051343.p003

186. Ft-0624734

187. Sw196402-3

188. 3,3''''''''-methylenebis[4-hydroxycoumarin

189. 3,3'-methylene-bis(4-hydroxycoumarin), 99%

190. A14241

191. C00796

192. D03798

193. D91292

194. 3,3''''''''-methylenebis(4-hydroxy-coumarin

195. 3,3''''''''-methylenebis(4-hydroxycoumarin)

196. Ab00051966_05

197. Coumarin, 3,3'-methylenebis[4-hydroxy- (8ci)

198. Q420886

199. Sr-05000001605-1

200. Sr-05000001605-3

201. Sr-05000001605-4

202. W-203471

203. Brd-k82236179-001-05-0

204. Brd-k82236179-001-06-8

205. Z57170530

206. 2h-1-benzopyran-2-one, 3,3'-methylenebis[4-hydroxy- (9ci)

207. Dicumarol, United States Pharmacopeia (usp) Reference Standard

208. 4-hydroxy-3-[(4-hydroxy-2-oxo-chromen-3-yl)methyl]chromen-2-one

2.4 Create Date
2011-12-26
3 Chemical and Physical Properties
Molecular Weight 336.3 g/mol
Molecular Formula C19H12O6
XLogP32.6
Hydrogen Bond Donor Count2
Hydrogen Bond Acceptor Count6
Rotatable Bond Count2
Exact Mass336.06338810 g/mol
Monoisotopic Mass336.06338810 g/mol
Topological Polar Surface Area93.1 Ų
Heavy Atom Count25
Formal Charge0
Complexity605
Isotope Atom Count0
Defined Atom Stereocenter Count0
Undefined Atom Stereocenter Count0
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Therapeutic Uses

Anticoagulants; Enzyme Inhibitors; Uncoupling Agents

National Library of Medicine's Medical Subject Headings online file (MeSH, 1999)


Anticoagulants are indicated for prophylaxis and/or treatment of venous (or arterial) thrombosis (and its extension) and pulmonary embolism /Not included in US product labeling/, deep vein thrombosis (DVT) or pulmonary embolism (treatment). Oral anticoagulants are used during and following initial heparin therapy to decrease the risk of extension, recurrence, or death. /Anticoagulants; Included in US product labeling/

MICROMEDEX Thomson Health Care. USPDI - Drug Information for the Health Care Professional. 22nd ed. Volume 1. MICROMEDEX Thomson Health Care, Greenwood Village, CO. 2002. Content Reviewed and Approved by the U.S. Pharmacopeial Convention, Inc., p. 265


Oral anticoagulants are used to prevent thromboembolic complications after surgery, although low-dose subcutaneous heparin is used more commonly. /Anticoagulants; Included in US product labeling/

MICROMEDEX Thomson Health Care. USPDI - Drug Information for the Health Care Professional. 22nd ed. Volume 1. MICROMEDEX Thomson Health Care, Greenwood Village, CO. 2002. Content Reviewed and Approved by the U.S. Pharmacopeial Convention, Inc., p. 265


Anticoagulants are indicated for prophylaxis and/or treatment of thromboembolic complications (ischemic stroke) associated with atrial fibrillation. They are strongly recommended in patients at high risk of stroke (including patients with recent stroke, transient ischemic attack, or systemic embolism; poor left ventricular function; age over 75 years; hypertension; rheumatic mitral valve disease; mechanical or tissue prosthetic heart valves.) /Anticoagulants; Included in US product labeling/

MICROMEDEX Thomson Health Care. USPDI - Drug Information for the Health Care Professional. 22nd ed. Volume 1. MICROMEDEX Thomson Health Care, Greenwood Village, CO. 2002. Content Reviewed and Approved by the U.S. Pharmacopeial Convention, Inc., p. 265


For more Therapeutic Uses (Complete) data for DICUMAROL (9 total), please visit the HSDB record page.


4.2 Drug Warning

Contraindications to oral anticoagulants include pre-existing or coexisting abnormalities of blood coagulation, active bleeding, recent or imminent surgery of the central nervous system or eye, diagnostic or therapeutic procedures with potential for uncontrollable bleeding including lumbar puncture, malignant hypertension, peptic ulceration, pregnancy, threatened abortion, intrauterine device, cerebrovascular hemorrhage, and bacterial endocarditis. Relative contraindications include thrombocytopenia, pericarditis, pericardial effusions, and unreliability of the patient or of patient supervision. /Oral anticoagulants/

Haddad, L.M., Clinical Management of Poisoning and Drug Overdose. 2nd ed. Philadelphia, PA: W.B. Saunders Co., 1990., p. 308


Most commonly, oral anticoagulant-induced bleeding is minor and consists of bruising, hematuria, epistaxis, conjunctival hemorrhage, minor gastrointestinal bleeding, bleeding from wounds and sites of trauma, and vaginal bleeding. More serious major or fatal bleeding is most commonly gastrointestinal, intracranial, vaginal, retroperitoneal, or related to a wound or site of trauma, although a large variety of other sites of bleeding have been reported. Intracranial bleeding occurs most frequently in patients receiving oral anticoagulants for cerebrovascular disease and most commonly presents as a subdural hematoma, often unassociated with head trauma. Fatal gastrointestinal bleeding is most commonly from a peptic ulcer, although any gastrointestinal lesion may be a potential source of major bleeding. Overall, a bleeding lesion can be identified in about two thirds of cases of oral anticoagulants-related hemorrhage. /Oral anticoagulants/

Haddad, L.M., Clinical Management of Poisoning and Drug Overdose. 2nd ed. Philadelphia, PA: W.B. Saunders Co., 1990., p. 311


Overall, the bleeding rate of oral anticoagulant therapy is influenced by several factors: the intensity of anticoagulation, either intentionally or inadvertent; the underlying clinical disorder for which anticoagulant therapy is used (with bleeding occurring most frequently in ischemic cerebrovascular disease and venous thromboembolism; and, with bleeding occurring most commonly in the elderly; the presence of adverse drug interactions or comorbid factors such as clinical states potentiating warfarin action, pre-existing hemorrhagic diathesis, malignancy, recent surgery, trauma, or pre-existing potential bleeding sites (e.g., surgical wound, peptic ulcer, recent cerebral hemorrhage, carcinoma of colon); the simultaneous use of aspirin (but not of dipyridamole); and patient reliability (e.g., increased bleeding in alcoholics not due to ethanol-warfarin drug interaction but rather to unreliability of drug intake). /Oral anticoagulants/

Haddad, L.M., Clinical Management of Poisoning and Drug Overdose. 2nd ed. Philadelphia, PA: W.B. Saunders Co., 1990., p. 310


Spontaneous abortion and stillbirth have occurred, as well as low birth weight and growth retardation. In addition, fetal or neonatal hemorrhage, fetal death from hemorrhage in utero, and increased risk of maternal hemorrhage during the second and third trimesters have been reported. There is some evidence that embryopathy occurs only with oral anticoagulant administration between the 6th and 12th weeks of gestation. /Anticoagulants/

MICROMEDEX Thomson Health Care. USPDI - Drug Information for the Health Care Professional. 22nd ed. Volume 1. MICROMEDEX Thomson Health Care, Greenwood Village, CO. 2002. Content Reviewed and Approved by the U.S. Pharmacopeial Convention, Inc., p. 267


For more Drug Warnings (Complete) data for DICUMAROL (34 total), please visit the HSDB record page.


4.3 Drug Indication

For decreasing blood clotting. Often used along with heparin for treatment of deep vein thrombosis.


5 Pharmacology and Biochemistry
5.1 Pharmacology

Dicumarol is an coumarin-like compound found in sweet clover. It is used as an oral anticoagulant and acts by inhibiting the hepatic synthesis of vitamin K-dependent coagulation factors (prothrombin and factors VII, IX, and X).


5.2 MeSH Pharmacological Classification

Anticoagulants

Agents that prevent BLOOD CLOTTING. (See all compounds classified as Anticoagulants.)


Enzyme Inhibitors

Compounds or agents that combine with an enzyme in such a manner as to prevent the normal substrate-enzyme combination and the catalytic reaction. (See all compounds classified as Enzyme Inhibitors.)


Uncoupling Agents

Chemical agents that uncouple oxidation from phosphorylation in the metabolic cycle so that ATP synthesis does not occur. Included here are those IONOPHORES that disrupt electron transfer by short-circuiting the proton gradient across mitochondrial membranes. (See all compounds classified as Uncoupling Agents.)


5.3 ATC Code

B - Blood and blood forming organs

B01 - Antithrombotic agents

B01A - Antithrombotic agents

B01AA - Vitamin k antagonists

B01AA01 - Dicoumarol


5.4 Absorption, Distribution and Excretion

Considerable individual variation in t/2 of dicumarol has been attributed to genetic factors. ... dicumarol...hydroxylated to inactive compounds by enzymes of hepatic endoplasmic reticulum. These metabolites and traces of parent drugs are excreted in urine. Some unabsorbed dicumarol appears in feces.

Goodman, L.S., and A. Gilman. (eds.) The Pharmacological Basis of Therapeutics. 5th ed. New York: Macmillan Publishing Co., Inc., 1975., p. 1359


In man, absorption of dicumarol from gi tract is slow and erratic. ... There is considerable variation in absorption from one individual to another. Within circulation...almost entirely but loosely bound to plasma albumin, & only small percentage of total plasma concentration is represented by unbound drug. ... Appreciable amount ...found in erythrocytes, but little or none is present in cerebrospinal fluid. ...accumulate/s/ mainly in lung, liver, spleen and kidney.

Goodman, L.S., and A. Gilman. (eds.) The Pharmacological Basis of Therapeutics. 5th ed. New York: Macmillan Publishing Co., Inc., 1975., p. 1358


Whole-body autoradiography of rats given anticoagulant, [(14)C]-dicumarol by intracardiac injection, indicated that (14)C distributed in most tissues, maximally in liver, lungs, heart, and kidneys. After 24 hr, (14)C levels were high in intestinal tract owing, presumably, to biliary excretion. Initially, iv dose of dicoumarol was more readily excreted in bile than in urine; in 3 hr, 4% was eliminated in bile and less than 0.4% in urine.

The Chemical Society. Foreign Compound Metabolism in Mammals. Volume 2: A Review of the Literature Published Between 1970 and 1971. London: The Chemical Society, 1972., p. 74


...71% of iv dose of...[(14)C]-dicoumarol, was excreted in feces and 23% in urine in 5 days.

The Chemical Society. Foreign Compound Metabolism in Mammals. Volume 1: A Review of the Literature Published Between 1960 and 1969. London: The Chemical Society, 1970., p. 43


5.5 Metabolism/Metabolites

Dicoumarol is not conjugated in either man or dog...

Parke, D. V. The Biochemistry of Foreign Compounds. Oxford: Pergamon Press, 1968., p. 151


Dicumarol...hydroxylated to inactive cmpd by enzymes of hepatic endoplasmic reticulum.

Goodman, L.S., and A. Gilman. (eds.) The Pharmacological Basis of Therapeutics. 5th ed. New York: Macmillan Publishing Co., Inc., 1975., p. 1359


Despite their structural similarity to coumarin, the anticoagulants dicumarol and warfarin do not appear to be substrates for CYP2A6. The overall rate of dicumarol metabolism varied approx 5 fold among the human liver microsomal samples, but this variation correlated poorly (r2= 0.126) with the variation observed in CYP2A6 levels and hydroxycoumarin levels.

PMID:1381906 Pearce R et al; Arch Biochem Biophys 298 (1): 211-25 (1992)


5.6 Biological Half-Life

1-2 days


...T/2 of dicumarol is dose dependent, ranging from 10 hr at low dosage to 30 hr at high dosage.

Goodman, L.S., and A. Gilman. (eds.) The Pharmacological Basis of Therapeutics. 5th ed. New York: Macmillan Publishing Co., Inc., 1975., p. 1358


Dicumarol has a dose dependent plasma half-life (one to two days); therapy is therefore somewhat difficult to control and frequent monitoring is usually indicated.

American Medical Association, Council on Drugs. AMA Drug Evaluations Annual 1994. Chicago, IL: American Medical Association, 1994., p. 742


Elimination half-life: 1 to 2 days

MICROMEDEX Thomson Health Care. USPDI - Drug Information for the Health Care Professional. 22nd ed. Volume 1. MICROMEDEX Thomson Health Care, Greenwood Village, CO. 2002. Content Reviewed and Approved by the U.S. Pharmacopeial Convention, Inc., p. 266


5.7 Mechanism of Action

Dicumarol inhibits vitamin K reductase, resulting in depletion of the reduced form of vitamin K (vitamin KH2). As vitamin K is a cofactor for the carboxylation of glutamate residues on the N-terminal regions of vitamin K-dependent proteins, this limits the gamma-carboxylation and subsequent activation of the vitamin K-dependent coagulant proteins. The synthesis of vitamin K-dependent coagulation factors II, VII, IX, and X and anticoagulant proteins C and S is inhibited. Depression of three of the four vitamin K-dependent coagulation factors (factors II, VII, and X) results in decresed prothrombin levels and a decrease in the amount of thrombin generated and bound to fibrin. This reduces the thrombogenicity of clots.


These compounds depress the hepatic synthesis of vitamin K1-dependent clotting factors (II, VII, IX, X) by inhibiting the vitamin K1 2,3-reductase enzyme in the vitamin K1-epoxide cycle. /Anticoagulant rodenticides/

Ellenhorn, M.J. and D.G. Barceloux. Medical Toxicology - Diagnosis and Treatment of Human Poisoning. New York, NY: Elsevier Science Publishing Co., Inc. 1988., p. 1084


The oral anticoagulants block the regeneration of reduced vitamin K and thereby induce a state of functional vitamin K deficiency. The mechanism of the inhibition of reductase(s) by the coumarin drugs is not known. There exist reductases that are less sensitive to these drugs but that act only at relatively high concentrations of oxidized vitamin K; this property may explain the observation that administration of sufficient vitamin K can counteract even large doses of oral anticoagulants. /Oral Anticoagulants/

Hardman, J.G., L.E. Limbird, P.B., A.G. Gilman. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 10th ed. New York, NY: McGraw-Hill, 2001., p. 1527


Dicumarol a specific and potent inhibitor of DT-diaphorase.

PMID:2455523 Atallah AS et al; Biochem Pharmacol 37 (12): 2451-9 (1988)


4-Hydroxycoumarin deriv (dicumarol...) Inhibit rat liver /drug metabolizing enzymes/ in vitro. Mechanism is complex, being caused by several factors, including conversion of cytochrome P450 into P420, inhibition of NADPH-cytochrome P450 reductase, and competition for active site.

The Chemical Society. Foreign Compound Metabolism in Mammals Volume 3. London: The Chemical Society, 1975., p. 496


For more Mechanism of Action (Complete) data for DICUMAROL (7 total), please visit the HSDB record page.