Journal of Thrombosis and Thrombolysis

, Volume 37, Issue 3, pp 372–379

Transitioning to and from the novel oral anticoagulants: a management strategy for clinicians

Article

Abstract

Vitamin K antagonists have been the only available oral anticoagulant therapy for decades until the recent introduction of novel (new) oral anticoagulants. This breakthrough provides patients with alternative treatment choices that have predictable pharmacokinetics and do not require routine coagulation monitoring. Though more convenient from patient perspective, these drugs have distinct pharmacological properties that are particularly important to recognize when transitioning anticoagulant therapies. The following review focuses on transitioning to and from the novel oral anticoagulants, employing a practical pharmacokinetic- and pharmacodynamic-based approach.

Keywords

Oral anticoagulants Transitions of anticoagulants Dabigatran Rivaroxaban Apixaban Edoxaban 

Abbreviations

NOAC

Novel oral anticoagulants

VKA

Vitamin K antagonists

VTE

Venous thromboembolism

AF

Atrial fibrillation

UFH

Unfractionated heparin

LMWH

Low molecular weight heparin

INR

International normalized ratio

aPTT

Activated partial thromboplastin time

P-gp

P-glycoprotein

GFR

Glomerular filtration rate

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Division of Cardiovascular Health and Disease, University of Cincinnati College of MedicineUniversity of CincinnatiCincinnatiUSA

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