SUMMARY OF ORAL ANTICOAGULANTS Apixaban Dabigatran* Edoxaban Rivaroxaban Vitamin K antagonists: Warfarin, phenindione Class Direct inhibitor Direct thrombin Direct and Direct inhibitor Vitamin K antagonists of factor Xa inhibitor reversible of factor Xa inhibitor of factor Xa Dose form available 2.5mg and 5mg 75mg, 110mg 15mg, 30mg 2.5mg, Warfarin: tablets and 150mg and 60mg 10mg,15mg and 500micrograms, 1mg, capsules tablets 20mg tablets 3mg and 5mg tablets 1mg/ml oral suspension Phenindione : 10mg and 25mg tablets Routine anticoagulant No No No No INR monitoring required Regular monitoring Renal function Renal function Renal function Renal function None Prophylaxis of VTE post Yes Yes No Yes No TKR and THR Treatment of DVT/PE Yes Yes, following at least 5 days of Yes Yes, may require at LMWH least 5 days of LMWH Prophylaxis of Yes Yes Yes Yes Yes recurrent DVT/PE Stroke and systemic Yes Yes Yes Yes Yes embolism prevention in non valvular AF Stroke prevention in No No No No Yes valvular AF Use in patients with No No No No Yes prosthetic valve Contraindicated where Yes Yes Yes Yes No CrCl<15ml/min Contraindicated where Dose reduction Yes Dose reduction Dose reduction No CrCl 15-29ml/min Contraindicated where No Dose reduction Dose reduction Dose reduction No CrCl 30-50ml/min Reversal agent No Idarucizumab No No Phytomenadione (Praxbind) Suitable in dossette Yes No Yes Yes No due to variable dosing Can be crushed Yes No Yes Yes Yes Can be administered Yes, NG tube No Yes Yes, NG and PEG Warfarin: Yes, NG and via enteral feeding PEG tube Risk of reduced absorption if using NJ/PEJ/PEGJ tube- monitor patient closely for effect
*Dabigatran is not a first line choice
Summary of anticoagulants Prepared by: Nike Abioye Checked by: Jane Caisley Review date: December 2022
References 1. British National Formulary (online). Individual drug monographs. Accessed via http://www.medicinescomplete.com on 23/07/2019 2. The NEWT guidelines for administration of medication to patients with enteral feeding tubes or swallowing difficulties (online). Accessed via www.newtguidelines.com on 30/12/19 3. Handbook of Drug Administration via Enteral feeding Tubes (online). Accessed via http://www.medicinescomplete.com on 23/07/2019 4. Boehringer Ingelheim Limited. Summary of Product Characteristics. Pradaxa hard capsules. Last updated 20/05/2019. Accessed via http://emc.medicines.org.uk/ on 24/07/2019 5. Bristol-Myers Squibb-Pfizer. Summary of Product Characteristics. Eliquis film-coated tablets. Last updated 08/07/2019. Accessed via http://emc.medicines.org.uk/ on 24/07/2019 6. Bayer plc. Summary of Product Characteristics. Xarelto film-coated tablets. Last updated 16/07/2019. Accessed via http://emc.medicines.org.uk/ on 24/07/2019 7. Bayer plc. Summary of Product Characteristics. Lixiana film-coated tablets. Last updated 03/07/2019. Accessed via http://emc.medicines.org.uk/ on 24/07/2019 8. The Renal Drug Database. Individual drug monographs. Accessed via https://renaldrugdatabase.com/ on 30/12/2019
Summary of anticoagulants Prepared by: Nike Abioye Checked by: Jane Caisley Review date: December 2022