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What’s New with Oral Anticoagulants?


Oral anticoagulants are created to prevent the increase or occurrence of unwanted blood clots. Compared to Warfarin, novel oral anticoagulants (NOACs) don’t require frequent monitoring and have less intra- and inter-patient variability. Although issues exist between these medications, NOACs have overall similar indications like reducing the risk of systematic embolism and stroke as well as treating and preventing deep vein thrombosis and pulmonary embolism. These medicines have been used increasingly in the last few years and can be bought in a reputable pharmacy in Ontario. However, there is a debate on whether their benefits outweigh the potential risks they may carry.
Positive Results for Heart Issues

Recently, the maker of anticoagulant Xarelto announced the results of a study that depicted the ability of the drug to minimize the occurrence of major cardiac episodes. This announcement was made after a consumer safety group warned consumers about the risks of internal bleeding from the drug group that also includes Eliquis and Pradaxa.

The Data Monitoring Committee carried out the recent Phase III COMPASS trial measuring the impact of Xarelto on heart injuries. There were reports stating the results of the trial were positive.

A study of over 27, 4000 patients globally compared the occurrence rates of cardiac episodes among patients given only aspirin, patients given only Xarelto and patients given a combination of aspirin and Xarelto. Results showed that Xarelto can prevent major cardiac events like stroke, cardiovascular death, and heart attacks.

Concerns on Internal Bleeding Risks

In terms of the use of NOACs, the most adverse reactions are related to an increased risk of bleeding which can be serious and even fatal. It is important to educate patients on the signs and symptoms of blood loss. Medicines which evoke an increased risk of bleeding will increase such risk further. Other adverse reactions include gastrointestinal reactions like gastroesophageal reflux disease and dyspepsia.

Advice on Contraindications and Warnings

Below are contraindications applicable to the three oral anticoagulants cited above for all indications and doses.

• Recent or current gastrointestinal ulceration
• Suspected or known esophageal varices
• Recent spinal or brain injury
• Arteriovenous malformation
• Presence of malignant neoplasm at risk of bleeding

Advice for Healthcare Professionals

• Paying attention to renal function. Patients with impaired renal function may not be allowed to take an anticoagulant medicine or get a dose reduction. Doctor’s recommendation differs for the three oral anticoagulants.

• Considering other patient conditions. Doctors must take special care when prescribing anticoagulant medicines to patients who suffer from other conditions, have other concomitant treatments and go through other procedures that are likely to increase the risk of major bleeding.

• Other important considerations. The precautions, warning, posology, and contraindications for use that are specific for every anticoagulant medicine, along with the patient’s risk factor for bleeding, must be taken into account before prescribing anticoagulants.

It is imperative to note that there’s no particular antidote for any of the three oral anticoagulants cited here. So read the product information for treatment advice in case of overdose or bleeding complication. Also, when buying these medicines, spend time talking to our pharmacists from some helpful advice. Please call 905-433-2002 to order your anticoagulant medicines and other medical supplies in Canada.


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