The following newer oral anticoagulants are available in Australia.
- Rivaroxaban (Xarelto®)
- Dabigatran (Pradaxa®)
- Apixaban (Eliquis®)
Patients may be initiated on these agents whilst in hospital or in the community for a number of indications.
For a broad overview of these medications, which are now in regular use, please read the NSW Health Safety Notice Newer Oral Anticoagulants, Clinical Safety Quality and Governance Branch, November 2011. Patients may present with overdose, bleeding or with no specific complications.
Further References and Resources
Find here a set of papers and online posts from various authors discussing important practice changes or potential changes:
- Interruption of Anticoagulation Medscape interview
Beam, D, Kahler, Z & Kline, J (2015) Immediate discharge and home treatment with rivaroxaban of low-risk venous thromboembolism diagnosed in two U.S emergency departments: a one-year preplanned analysis, Academic Emergency Medicine, vol. 22, no. 7, pp. 788-795.
St. Emlyn's Blog - ED coagulopathy detection
St. Emlyn's Blog - Get NOACc Knowhow: Novel Oral Anticoagulants - Part 1
Medscape Paper 1 (requires login)
Medscape Paper 2 (requires login) In a patient with cirrhosis, INR is a poor predictor of bleeding risk and the common practice of transfusing fresh frozen plasma before surgery or procedures in otherwise stable patients with liver disease and an elevated INR is questionable.” This recent discussion looks at a common but is it right practice.