Capisheal

Adrenochrome Monosemicarbazone (50IU) + Rutin (10IU) + Menadione Sodium Bisulfite (200IU) + Vitamin D (125mg) + Calcium Phosphate (37.5mg)
Price: ₹100 - ₹150 for strip of 10 tablets
Mfr: Mankind Pharma Ltd | Form: Tablet

📋 Clinical Overview

A fixed-dose combination product primarily indicated for the management of capillary fragility and bleeding disorders. It combines a hemostatic agent (Adrenochrome Monosemicarbazone), a capillary stabilizer (Rutin), a synthetic vitamin K analogue (Menadione Sodium Bisulfite), and bone mineral components (Vitamin D and Calcium Phosphate). It is used to reduce bleeding time, strengthen capillary walls, and support coagulation, often in conditions like hemorrhagic diathesis, epistaxis, and menorrhagia.

💊 Dosage & Administration

Adult: One tablet twice or thrice daily, or as directed by the physician. Typically after meals.

Note: Administer orally with or after food to minimize gastric irritation and enhance absorption of fat-soluble components. Tablet should be swallowed whole with a full glass of water. Do not crush or chew.

⚠️ Contraindications

  • Hypersensitivity to any component
  • Hypercalcemia (elevated serum calcium)
  • Hypervitaminosis D
  • Severe renal impairment (eGFR <30 mL/min) due to risk of hypercalcemia and phosphate load
  • Thrombotic tendencies or history of thromboembolism (theoretical risk with pro-coagulant effect)

🔬 Mechanism of Action

Adrenochrome Monosemicarbazone stabilizes capillary endothelium and promotes platelet adhesion, reducing capillary permeability and bleeding time. Rutin (a bioflavonoid) exerts antioxidant and anti-inflammatory effects, reducing capillary fragility. Menadione Sodium Bisulfite is a water-soluble pro-vitamin K, serving as a precursor for the synthesis of active vitamin K-dependent clotting factors (II, VII, IX, X) in the liver. Vitamin D (Cholecalciferol) enhances intestinal absorption of calcium and phosphate. Calcium Phosphate provides elemental calcium and phosphate, essential for blood coagulation (as Factor IV), neuromuscular function, and bone mineralization.

🤕 Side Effects

  • Nausea
  • Epigastric discomfort
  • Headache
  • Flushing or sensation of warmth

🤰 Special Populations

Pregnancy: Category C: Use only if clearly needed. Safety not established. Menadione has been associated with kernicterus in newborns when used in high doses late in pregnancy. Benefit must outweigh risk.

Driving: Unlikely to affect driving ability. However, dizziness or flushing may occur rarely; caution advised if these symptoms are experienced.

🔄 Drug Interactions

Warfarin and other Vitamin K AntagonistsMenadione can antagonize the anticoagulant effect, reducing INR. Risk of treatment failure.Major
Thiazide Diuretics (e.g., Hydrochlorothiazide)Reduce calcium excretion, increasing risk of hypercalcemia.Moderate
DigoxinHypercalcemia can potentiate digoxin toxicity, leading to serious arrhythmias.Major
Oral Tetracycline/Quinolone AntibioticsCalcium can chelate these drugs, reducing their absorption. Administer at least 2-3 hours apart.Moderate
Corticosteroids (e.g., Prednisolone)Reduce calcium absorption and may antagonize vitamin D effect.Moderate
Orlistat, CholestyramineReduce absorption of fat-soluble vitamins (Vitamin D, Menadione).Moderate
Phenytoin, PhenobarbitalIncrease metabolism of Vitamin D, reducing its efficacy.Moderate

🔁 Alternatives to Capisheal

Same composition (Adrenochrome Monosemicarbazone (50IU) + Rutin (10IU) + Menadione Sodium Bisulfite (200IU) + Vitamin D (125mg) + Calcium Phosphate (37.5mg)), different brands:

Styptovit Rutin-K2 Hemostop