Novel Oral Anticoagulant Cheat Sheet



DrugDabigatran (Pradaxa)Rivaroxaban (Xarelto)Apixaban (Eliquis)Edoxaban (Savaysa)MechanismDirect thrombin inhibitorFactor Xa inhibitorFactor Xa inhibitorFactor Xa inhibitor -Half-life12-17 hours7-9 hours12 hours10-14 hours -OnsetTherapeutic in 1-2 hoursTherapeutic levels in 1-2 hoursTherapeutic levels in 1-2h Therapeutic levels in 1-2h Dosing Information -DVT prophylaxisNo indication10mg PO daily -CrCl <30mL/min: Avoid use2.5mg PO BIDNo indication -Nonvalvular A. fib150mg PO BID -CrCl < 30mL/min: 75mg PO BID20mg PO qD -CrCl 15-50mL/min: 15mg POqD -CrCl <15mL/min: Avoid use5mg PO BID2.5mg PO BID if ≥ 2 risks: -Age ≥ 80 -Cr ≥ 1.5 -Weight ≤ 60kg60mg PO daily30mg PO daily if -CrCl 15-50mL/minDo not use if CrCl ≥ 95, due to increased risk of thrombosis -VTE treatment150mg PO BID if CrCl > 30mL/minInitiate after 5 days of parenteral anticoagulation15mg PO BID x 3 weeks, then 20mg PO daily -CrCl <30mL/min: Avoid use10mg PO BID x 7 days, then 5mg PO BID60mg PO daily30mg PO daily if -CrCl 15-50mL/min -Weight ≤ 60kgafter 5 days parenteral therapyContraindications - Allergy- Active bleeding- Allergy- Active bleeding- Allergy- Active bleeding- Allergy- Active bleedingCautions -Procedures- Epidural anesthesia- Lumbar puncture- Epidural anesthesia- Lumbar puncture- Epidural anesthesia- Lumbar puncture - Epidural anesthesia- Lumbar puncture -Pregnancy CategoryCCBC -LactationDiscontinue DrugDiscontinue drugDiscontinue drugDiscontinue drug -PediatricsUnknownUnknownUnknownUnknownRenal impairmentProlongs half-life. Adjust dosing.Avoid if CrCl<15Not significantCrCl 15-50mL/min: reduce doseAvoid drug if CrCl <15Hepatic impairmentUnclear data. Avoid if moderate to severe imapirmentAvoid in patients with Child-Pugh B and C or coagulopathyNot significantAvoid if moderate to severe hepatic impairmentReversal agentNonePCC doesn’t workTargeted agent in Phase 3 trialsPCC is probably effectiveTargeted agent in Phase 3 trialsPCC is probably effectiveNonePCC is probably effectiveHold time for Procedures48 hours prior to procedure24-48 hours prior to procedure24-48 hours prior to procedure24-48 hours prior to procedure ................
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