Education Blog for Healthcare Professionals

Archive for the ‘Xarelto (Rivaroxaban)’ Category

ACCP Guideline for DVT and PE Treatment: New Edition, 2016

| Anticoagulants, Aspirin, Plavix, Aggrenox, Tiklid, Persantine, Edoxaban, Eliquis, Guideline, Pradaxa (dabigatran), Therapy, Uncategorized, Xarelto (Rivaroxaban) | Comments Off on ACCP Guideline for DVT and PE Treatment: New Edition, 2016

The ACCP Chest Guidelines have been the main guide over the last more than 2 decades for evidence-based recommendations on best management of anticoagulants for various indications, including DVT and PE.  The 10th edition of the chapter on DVT and PE management was published in Jan 2016 [ref 1]. Unfortunately, the guideline is not available for non-subscribers. Read the rest of this entry »

Fourth NOAC FDA Approved for DVT, PE and Atrial Fibrillation: Savaysa (Edoxaban)

| Edoxaban, Eliquis, Pradaxa (dabigatran), Uncategorized, Xarelto (Rivaroxaban) | Comments Off on Fourth NOAC FDA Approved for DVT, PE and Atrial Fibrillation: Savaysa (Edoxaban)

Stephan Moll, MD writes…. Today (Jan 8th, 2015) the FDA approved yet another new oral anticoagulant, Savaysa (edoxaban), for the treatment of DVT and PE, as well as for atrial fibrillation. The FDA press release  is here (link).  Savaysa is the 4th of the NOACS now approved for VTE treatment. This table summarizes the differences, advantages and disadvantages comparing the 4 drugs. The detailed drug package insert with dosing information is here (link). Read the rest of this entry »

Antidotes for the New Oral Anticoagulants: Update

| Anticoagulants, Bleeding, Eliquis, Pradaxa (dabigatran), Uncategorized, Xarelto (Rivaroxaban) | Comments Off on Antidotes for the New Oral Anticoagulants: Update

Stephan Moll, MD writes (on Nov 7th, 2014)… A N Engl J Med publication this week [ref 1] reports on a new reversal agent (PER977 = Aripazine = ciraparantag) that may be effective against a number of different new oral anticoagulants. Read the rest of this entry »

Pradaxa (Dabigatran) FDA-Approved for DVT and PE

| Eliquis, Pradaxa (dabigatran), Therapy, Uncategorized, Xarelto (Rivaroxaban) | Comments Off on Pradaxa (Dabigatran) FDA-Approved for DVT and PE

Stephan Moll, MD writes…  Today the FDA approved Pradaxa (dabigatran) for the treatment of venous thromboembolism, based on the phase 3 RECOVER and RECOVER II trials.  The dose is 150 mg twice daily for patients with a GFR > 30 ml/min.  Due to the design of the RECOVER and RECOVER II trials, the drug is approved to be used in the patient with acute DVT or PE only AFTER 5-10 days of a parenteral anticoagulant have been given –  not immediately from day zero onwards.   The full package insert is here.  The press release from Boehringer-Ingelheim is here.   The FDA approval status of the four big new oral anticoagulants for the various indications is summarized  in this table.

 

Disclosures:  I have been a consultant for Boehringer-Ingelheim,  Daiichi, and Janssen.

Last updated:  April 7th, 2014

Pregnancy, Breastfeeding – Safety of Various Anticoagulants

| Anticoagulants, Eliquis, Fondaparinux (Arixtra), LMWH, Pradaxa (dabigatran), Uncategorized, Warfarin (Coumadin), Xarelto (Rivaroxaban) | Comments Off on Pregnancy, Breastfeeding – Safety of Various Anticoagulants

Stephan Moll, MD writes… LMWH (low molecular weight heparin) is the preferred anticoagulant in the pregnant patient. LMWH and warfarin are safe in the woman who is beast-feeding.

Rivaroxaban (Xarelto), dabigatran (Pradaxa) and apixaban (Eliquis) should not be used during pregnancy or while breastfeeding.

A detailed summary about the safety of the various anticoagulants during pregnancy and while breast-feeding, based on the ACCP 2012 guidelines [ref], can be found here.  Read the rest of this entry »

FDA to Review Eliquis (Apixaban) for DVT and PE Treatment

| Anticoagulants, Eliquis, Pradaxa (dabigatran), Uncategorized, Xarelto (Rivaroxaban) | Comments Off on FDA to Review Eliquis (Apixaban) for DVT and PE Treatment

Stephan Moll, MD writes… On Dec 19th the FDA accepted the application by Bristol-Myers Squibb (BMS) and Pfizer for review of Eliquis (apixaban) for the treatment of DVT and PE. The press release of BMS is here.  The goal date for a decision by the FDA is August 25, 2014. Read the rest of this entry »

Handout for Your Patients in Clinic – Which Anticoagulant to Use for DVT and PE

| Anticoagulants, Deep Vein Thrombosis (DVT), Eliquis, Pradaxa (dabigatran), Pulmonary Embolism, Uncategorized, Warfarin (Coumadin), Xarelto (Rivaroxaban) | Comments Off on Handout for Your Patients in Clinic – Which Anticoagulant to Use for DVT and PE

Stephan Moll, MD writes…  Patients who are on warfarin for a history of DVT or PE  may inquire whether a switch to one of the  new oral anticoagulants is appropriate.  Similarly, many physicians initiate this discussion with their patients.

This is, obviously, a detailed discussion and an individualized decision with a number of factors to be considered.  We have developed a two-page “Comparison of Oral Blood Thinners”  handout for patients, to assist with and summarize the discussion.  This sheet allows a structured  discussion with the patient about the pros and cons of the various anticoagulant choices.  The reader is welcome to print this resource and use it as a handout for his/her patients.

Disclosure:  I have been a consultant for  Boehringer-Ingelheim, Daiichi, and Janssen.

Last Updated:  Dec 19th, 2013