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Abstract
Four prothrombinopenic anticoagulants were compared under controlled conditions in
287 patients over a LAperiod of fourteen months. Somewhat better control was achieved
with bishydroxycoumarin and diphenadione than with phenindione and warfarin. The differences
were statistically significant but not great. Satisfactory control was achieved in
the majority of patients with all four drugs.
There was relatively wide variation in dosage requirements in the same patient from
day to day and among patients receiving the same preparation. This variation was less
with bishydroxycoumarin and diphenadione than with phenindione and warfarin, but the
differences were not sufficient to be clinically useful.
An induction schedule which consisted of a large single loading dose followed by a
small maintenance dose was found to be desirable and safe. Using such a program the
prothrombin activity in the majority of patients (82 per cent) was brought into the
therapeutic range within forty hours of the initial dose with all four drugs. This
program also facilitated the early establishment of a stable maintenance dose.
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© 1959 Published by Elsevier Inc.
