Clinical Evaluation of Acenocoumarol (Sintrom), an Anticoagulant of Intermediate Range

Acenocoumarol, an orally administered anticoagulant with intermediate duration of effect, was used in the treatment of 100 hospitalized patients. The largest group consisted of 28 patients with spontaneous acute peripheral phlebitis. The treatment was aimed to keep the prothrombin time within a therapeutic range of between 23 and 37 seconds. Many patients showed a wide range of variability, so that it was necessary to define a broader, clinically practical range between 20 and 43 seconds. The average initial dose proved to be 21 mg. of acenocoumarol, and in over one-third of the patients the prothrombin time was within the clinically practical range 18 hours later. The average maintenance dose was 6.6 mg. per day. Side-effects were few; no gastrointestinal intolerance was seen, and only five patients had minor bleeding episodes. Some patients continued to receive anticoagulant therapy on an ambulant basis after leaving the hospital, and one continued it for 64 days. This experience illustrated some significant advantages of acenocoumarol, especially the possibility of controlling the intensity of its effects and the time of their disappear