A comparative study of four prothrombinopenic anticoagulant drugs

II. Clinical study
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      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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