DEFINITION & INDICATIONS
DEFINITION
Oral anticoagulants: medications that prevent blood clot formation – Two main types:
- Vitamin K antagonists (Warfarin)
- Direct Oral Anticoagulants (DOACs) – Apixaban, Edoxaban, Rivaroxaban, Dabigatran
Warfarin:
- Blocks coagulation factors 2, 7, 9, 10
- Blocks anticoagulant proteins C and S
DOACs:
- Apixaban, Edoxaban, Rivaroxaban: block factor Xa
INDICATIONS
Warfarin:
- Rheumatic heart disease prophylaxis
- AF prophylaxis (DOACs mainly used)
- Prosthetic heart valve prophylaxis
- DVT/PE prophylaxis and treatment
- TIA prophylaxis
DOACs:
- Non-valvular AF, Stroke prevention (apixaban: 5 mg BD, long-term treatment) – DVT/PE treatment and prophylaxis
Treatment example: Apixaban: 10 mg of BD for 7 days, then 5 mg BD for 3 months Prophylaxis example: Apixaban: 2.5 mg BD
- Hip/knee replacement prophylaxis (Apixaban, Edoxaban, Dabigatran) Apixaban for joint replacement:
- Hip: 2.5mg BD for 32-38 days, start 12-24h post-op
- Knee: 2.5mg BD for 10-14 days, start 12-24h post-op
- Post-MI antithrombotic events (Rivaroxaban + in combo with antiplatelet)