Clinical Experience With Warfarin (Coumadin) Sodium, a New Anticoagulant

Although the presently available anticoagulants have been of great clinical usefulness, well-recognized defects are inherent in them. Heparin requires frequent parenteral administration and is costly. Bishydroxycoumarin (Dicumarol) has a long latent period between the time of administration and onset of therapeutic effect. Ethyl biscoumacetate (Tromexan) loses therapeutic effect within a few hours after reaching the therapeutic level, thus rendering smooth control of anticoagulant action difficult. Other of the newer anticoagulants posses undesirable side-reactions. A more nearly ideal anticoagulant continues to be a practical need. For this reason a clinical study has been conducted on warfarin (Coumadin) sodium, one of the group of coumarin drugs produced by Dr. Karl Paul Link and his group at the University of Wisconsin.¹The substance, 3-(α-phenyl-β-acetylethyl)-4-hydroxycoumarin, is highly active as a hypoprothrombinemic agent, is soluble and stable, and is suitable for intravenous use. The relationship of warfarin sodium to bishydroxycoumarin is shown in fig.