Oral Anticoagulants at a Glance
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Indications: For people with Afib, prosthetic heart valves, history of heart attack, and to prevent deep-vein thrombosis (DVT) and pulmonary embolism (PE). Dosing: Once daily with or without food; dosing based on periodic blood testing. Considerations: Periodic blood testing required; minimize intake of vitamin K (green leafy vegetables, broccoli, cauliflower, canola oil); may be preferred for patients with severe liver or kidney dysfunction; effects easily reversed; inexpensive (as low as $4 for a 30-day supply).
Warfarin (Coumadin )
Indications: For prevention of stroke in nonvalvular Afib; prevention of DVT and PE; DVT prophylaxis after knee or hip replacement surgery. Dosing: Twice daily with or without food. Considerations: No monitoring or dietary restrictions necessary; may be preferred for patients with recent history of gastrointestinal bleeding; reversal agent — andexanet alfa (Andexxa®) — available.
Apixaban (Eliquis )
Indications: For prevention of stroke in nonvalvular Afib; prevention of DVT and PE; DVT prophylaxis after knee or hip replacement surgery. Dosing: Twice daily with or without food; once-daily for DVT prophylaxis after hip or knee replacement surgery. Considerations: No monitoring or dietary restrictions necessary; reversal agent — idarucizumab (Praxbind®) — available; more likely than other anticoagulants to cause stomach upset; more affected by renal impairment than other DOACs.
Dabigatran (Pradaxa )
Indications: For prevention of stroke in nonvalvular Afib; prevention of DVT and PE. Dosing: Once daily with or without food. Considerations: No monitoring or dietary restrictions necessary; reversal agent pending regulatory approval.
Edoxaban (Savaysa )
Indications: For prevention of stroke in nonvalvular Afib; prevention of DVT and PE; DVT prophylaxis after knee or hip replacement surgery. Dosing: Once daily with or without food. Considerations: No monitoring or dietary restrictions necessary; reversal agent — andexanet alfa (Andexxa®) — available.
Rivaroxaban (Xarelto )
