New Medicines Service - Advice for Patients on Anticoagulant and Anti-Platelet Drugs

New Medicines Service - Advice for patients on Anticoagulant and Anti-platelet Drugs

Anticoagulant and anti-platelet drugs, as high risk medicines, are included under the New Medicines Service (NMS). NHS Sheffield CCG encourages pharmacists to use the facility of the NMS to re-inforce the message and confirm the patient understands their treatment.

Sheffield Teaching Hospital and NHS Sheffield CCG have developed guidance for prescribersi on the use of anticoagulants for prevention of stroke in atrial fibrillation, which includes the need to inform patients. Patients with atrial fibrillation who are newly prescribed anticoagulants to reduce stroke risk should have had a discussion with the doctor covering the following points:-

 Stroke and bleeding risk  Suitable anticoagulation options and the differences between them o Dosing o Monitoring o The effects of other medications, food and alcohol  How to use anticoagulants o The correct dose o What to do in case of a missed dose  Duration of anticoagulation treatment  Possible side effects and what to do if these occur

They may also have been provided with information covering:

 How anticoagulation may affect dental treatment  How anticoagulants may affect activities such as sports and travel  When and how to seek medical help  Women of childbearing potential who are taking anticoagulants should be advised to take contraceptive precautions and contact their GP urgently if they think they may be pregnant.  Rivaroxaban must be taken with food to ensure full absorption  Dabigatran should be taken with food to reduce the likelihood of heartburn/indigestion

Patient information resources:

 Warfarin – NPSA “yellow book”  Apixaban – Eliquis® o Booklets and patient alert cards can be ordered from Bristol-Myers Squibb Medical Information (telephone: 0800 731 1736; e-mail: [email protected])  Rivaroxaban – Xarelto® o Booklets and alert cards can be downloaded and printed from http://www.xarelto- info.co.uk/hcp/  Dabigatran – Pradaxa® patient information packs (leaflet and alert card) can be ordered from https://www.pradaxa.co.uk/ )

STH Patient information leaflets on each of the NOACs are currently being developed – when published they will be available on the STH patient information pagesii i http://www.intranet.sheffieldccg.nhs.uk/Downloads/Medicines%20Management/prescribing %20guidelines/Anticoagulation%20for%20stroke%20prevention%20in%20AF%20-%20Sheffield%20guidance%20- %20May%202015%20FINAL.pdf ii http://www.sth.nhs.uk/patients/patient-information/find-a-leaflet/search-for-a-leaflet