Toxic effects of phenindione

Although there is sharp controversy about the value of anticoagulants in the management of coronary artery and cerebrovascular disease, there is less controversy about their usefulness in the management of thrombophlebitis and other thrombo-embolic disorders. As for the choice of an anticoagulant drug, the occasional severity of side effects from phenindione, one of the indandione anticoagulants, has previously led the Medical Letter (U.S. ed. 1959, 1 , 85) to express a preference for dicoumarol, warfarin sodium and other coumarin drugs. More recent reports confirm the need for special caution in using phenindione (Dindevan - Evans Medical, and other manufacturers). It was introduced in 1947 and claimed to give an early, reliable and stable response, and to have less cumulative effect than the coumarin drugs.