Phenprocoumon, Diphenadione, Warfarin and Bishydroxycoumarin

Rodman, Theodore; Pastor, Bernard H.; Resnick, Myron E.

doi:10.1097/00000441-196406000-00003

Cited by 19 publications

(6 citation statements)

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“…During the subsequent six months the investigators observed that the patients who switched to phenprocoumon required about 10% fewer monitoring visits, were substantially more likely to have Thrombotest ® results within the therapeutic range and had significantly lower variance in Thrombotest ® results (13). Other investigators over the past four decades have made similar findings as well (11,(14)(15)(16)(17).…”

Section: Discussionmentioning

confidence: 80%

Comparison of control and stability of oral anticoagulant therapy using acenocoumarol versus phenprocoumon

Sd¹,

Aa²,

Pasterkamp³

et al. 2003

Thromb Haemost

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Variability in the control of oral anticoagulant therapy has been associated with a heightened risk of complications. We compared control of anticoagulation between two commonly used coumarins, phenprocoumon and acenocoumarol, and among anticoagulation clinics. All qualifying patients were managed at six regional anticoagulation clinics in the Netherlands. This retrospective cohort study compiled data during a three-year period from a computerised dosing and management system. Anticoagulation control was expressed as the percent of time within the therapeutic range and stability expressed as the time-weighted variance in the international normalised ratio (INR). Data were available for 22,178 patients of whom 72% were treated with acenocoumarol. INRs of patients who received phenprocoumon were within the therapeutic range 50% of the time compared with 43% for acenocoumarol (OR 1.32, 95% CI 1.24-1.41). Moreover, patients on phenprocoumon required 15% fewer monitoring visits and had more stable INR values. These observations were consistent for all six clinics. There were also sizable differences between the clinics with respect to control and stability of anticoagulation that were stable from year-to-year and were unrelated to the drug used. With its longer half-life of three to five days, phenprocoumon produces more stable anticoagulation than acenocoumarol and should generally be the drug of choice when these are the available choices. The differences observed among clinics suggest that certain clinics employ policies and practices resulting in better control of anticoagulation.

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Section: Discussionmentioning

confidence: 80%

Comparison of control and stability of oral anticoagulant therapy using acenocoumarol versus phenprocoumon

Sd¹,

Aa²,

Pasterkamp³

et al. 2003

Thromb Haemost

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“…More than 40 years ago, Rodman et al [18] compared four different anticoagulants, namely warfarin, phenprocoumon, diphenadione and dicoumarol among 126 patients in a randomized, controlled trial. They found that patients treated with phenprocoumon were in therapeutic range 95% of the time compared with 84% in patients treated with warfarin.…”

Section: Discussionmentioning

confidence: 99%

Quality of oral anticoagulant therapy in patients who perform self management: warfarin versus phenprocoumon

Jensen

Christensen

Maegaard

et al. 2008

J Thromb Thrombolysis

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“…They inhibit the production by the liver of the vitamin K‐dependent coagulation factors (factors II, VII, IX and X). A number of studies have suggested that longer‐acting coumarins give a more stable anticoagulation than short‐acting coumarins (Ensor & Peters, 1957; Simson, 1962; Rodman et al , 1964; Sullivan & Kozonis, 1965; Breed et al , 1969; Fekkes et al , 1971; Pattacini et al , 1994), which is thought to be associated with fluctuations in the plasma levels of factor VII induced by the shorter‐acting drugs (Loeliger et al , 1963; Kazmier et al , 1965; Thijssen et al , 1988). Detailed comparisons of different coumarins are rare, which is probably due to the geographical distribution of their use.…”

mentioning

confidence: 99%

Therapeutic quality control of oral anticoagulant therapy comparing the short‐acting acenocoumarol and the long‐acting phenprocoumon

Gadisseur

Meer

Adriaansen³

et al. 2002

Br J Haematol

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Summary. To investigate whether the different pharmacokinetics of acenocoumarol (t 1/2 ¼ 11 h) and phenprocoumon (t 1/2 ¼ 140 h) result in a different quality of anticoagulation, we studied patients from the Leiden anticoagulation clinic treated between 1998 and 1999 for more than 16 weeks. Two hundred and twenty-eight pairs were closely matched for indication for oral anticoagulant therapy (OAT), age, sex and date of start of treatment. Four hundred and fifty six patients with 7245 International Normalized Ratio (INR) checks yielded 230 patient-years. Quality of OAT calculated over the whole treatment period was higher with phenprocoumon as expressed by the number of INR checks in the therapeutic range (phenprocoumon: 42AE7%, acenocoumarol: 36AE5%, difference: 6AE1%, CI 95 of the difference: 3AE0-9AE3%) and by time in range (phenprocoumon: 46AE6%, acenocoumarol: 41AE6%, difference: 5AE0%, CI 95 of the difference: 1AE3-8AE6%). After the initial 6 weeks of OAT, the differences became more pronounced (difference: 6AE1%, CI 95 : 1AE8-10AE4%). The incidence of severe bleeding complications was similar (phenprocoumon: 0AE04/patient/year vs acenocoumarol: 0AE03/patient/ year) with a slight excess of minor bleeds with phenprocoumon (0AE19/patient/year vs 0AE06/patient/year). We conclude that phenprocoumon leads to a better quality of OAT than acenocoumarol. As there is no difference in major bleeding complications and only a small difference in minor bleeding complications, phenprocoumon is preferable to acenocoumarol for prolonged OAT.

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Phenprocoumon, Diphenadione, Warfarin and Bishydroxycoumarin

Cited by 19 publications

References 0 publications

Comparison of control and stability of oral anticoagulant therapy using acenocoumarol versus phenprocoumon

Comparison of control and stability of oral anticoagulant therapy using acenocoumarol versus phenprocoumon

Quality of oral anticoagulant therapy in patients who perform self management: warfarin versus phenprocoumon

Therapeutic quality control of oral anticoagulant therapy comparing the short‐acting acenocoumarol and the long‐acting phenprocoumon

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