NEJM - Ximelagatran versus Warfarin to Prevent Venous Thromboembolism after Total Knee Replacement: " The efficacy of ximelagatran, an orally administered thrombin inhibitor, was compared with that of warfarin for thromboprophylaxis after total knee replacement. Both drugs were given for 7 to 12 days postoperatively, ximelagatran at a dose of 24 or 36 mg twice daily and warfarin with a target international normalized ratio of 2.5. The higher dose of ximelagatran was superior to warfarin in the prevention of venous thrombosis. Ximelagatran does not require coagulation monitoring and hence can be given at a fixed dose. The short-term efficacy of this drug is promising, but its value for long-term anticoagulation is still unclear."

Another one of the new generation of anti coagulants. But transaminases might prove to be problem. - KK