Preventive Strategies against Bleeding due to Nonvitamin K Antagonist Oral Anticoagulants

Lessire, Sarah; Dincq, Anne-Sophie; Douxfils, Jonathan; Devalet, Bérangère; Nicolas, Jean Baptiste; Spinewine, Anne; Larock, Anne Sophie; Dogné, Jean Michel; Gourdin, Maximilien; Mullier, François

doi:10.1155/2014/616405

Cited by 6 publications

(1 citation statement)

References 86 publications

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“…The cost will gradually reduce to an affordable price [2]. Innovative protocols will be designed to minimize the possibility of haemorrhage [37]. Advanced studies will be carried out to determine dosing patterns for special populations such as pregnant and lactating women, geriatrics and paediatrics, and patients with renal and hepatic dysfunction [7].…”

Section: Future Trends Of Noacs (Conclusion)mentioning

confidence: 99%

NOACs: an emerging class of oral anticoagulants-a review article

Paul¹,

Baby²,

Anthraper³

et al. 2020

Futur J Pharm Sci

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Background NOACs, commonly known as novel oral anticoagulants, are the non-vitamin K antagonist oral anticoagulants which are relatively newer in the market. It has displaced vitamin K antagonists, notably warfarin, for many indications. These agents are dabigatran, rivaroxaban, apixaban, and edoxaban. Main body The drugs are licenced to prevent stroke and also systemic embolism in patients on treatment for atrial fibrillation and prevent venous thromboembolism. Rivaroxaban and apixaban are approved for prophylaxis of thrombus following surgical hip or knee arthroplasty. The recent surveys reveal that use of NOACs has steeply increased due to its safety profile and convenience to use. Also, the studies have shown that NOACs have lesser bleeding complications and associated mortality in contrast to traditional anticoagulants. The upcoming years are known to be NOACs’ age due to the significant findings in this area. Conclusion Therefore, a basic understanding on these drugs is highly recommended to provide a better service to the patients. This article aims to provide quick and brief information on the novel class of drugs. It equips an overview of NOAC and deals with the following areas: (i) pharmacology, (ii) laboratory methods, (iii) peri-operative management, (iv) advantages, (v) challenges, and (vi) future.

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Section: Future Trends Of Noacs (Conclusion)mentioning

confidence: 99%

NOACs: an emerging class of oral anticoagulants-a review article

Paul¹,

Baby²,

Anthraper³

et al. 2020

Futur J Pharm Sci

View full text Add to dashboard Cite

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Effect of tramadol and DOACs with special attention to dabigatran on concomitant use, on the risk of mayor bleeding using BIFAP database in Spain

Burgos-Gonzalez

Huerta

Peñalver

et al. 2022

Pharmacoepidemiology and Drug

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Background Tramadol, a weak opioid, inhibits the reuptake of serotonin, a key feature on vascular homeostasis. A suspected interaction exists between dabigatran and tramadol, which might trigger an excess on risk of bleeding however, there is a gap in knowledge on this topic. Purpose To estimate the effects of tramadol, dabigatran and concomitant use on the risk of hospitalized major bleeds (Gastrointestinal bleeding and intra‐extracranial bleeds). Methods Among a validated established cohort of new users of oral anticoagulants for non‐valvular atrial fibrillation (NVAF) aged 18 years or older, we identified all hospitalized bleed episodes (GIB and extra/intracranial bleeds) within 2008–2015. A nested case–control analysis was conducted using conditional logistic regression. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated for dabigatran, tramadol, and concomitant use. Several sensitivity analyses were carried out. Results aORs (95%CIs) for current use of only dabigatran, only tramadol and concomitant users were 1.73 (1.37–2.18) and 1.38 (1.13–1.67) and 2.04 (0.74–5.67) compared with non‐users of both drugs (>365 days). aORs for current continuers and non‐continuer users of dabigatran were 1.36 (1.00–1.86) and 2.19 (1.61–2.98), respectively. For the latter, non‐continuer users with a short duration of dabigatran cumulated the highest risk (3.36 [1.88–5.99]). There also was an increased risk with concomitant use of tramadol and rivaroxaban (2.24 [1.19–4.21]), or antagonist of vitamin K (1.30 [1.00–1.69]). Conclusion There was a trend towards and increased risk of excess bleeds when using concomitantly with dabigatran. The effect decreases with a narrower definition of current use.

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Bleeding Risk, Management and Outcome in Patients Receiving Non-VKA Oral Anticoagulants (NOACs)

Werth

Breslin

NíAinle

et al. 2015

Am J Cardiovasc Drugs

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Modern direct-acting anticoagulants are rapidly replacing vitamin K antagonists (VKA) in the management of millions of patients worldwide who require anticoagulation. These drugs include agents that inhibit activated factor X (FXa) (such as apixaban and rivaroxaban) or thrombin (such as dabigatran), and are collectively known today as non-VKA oral anticoagulants (NOACs). Since bleeding is the most common and most dangerous side effect of long-term anticoagulation, and because NOACs have very different mechanisms of action and pharmacokinetics compared with VKA, physicians are naturally concerned about the lack of experience regarding frequency, management and outcome of NOAC-associated bleeding in daily care. This review appraises trial and registry (or "real-world") data pertaining to bleeding complications in patients taking NOACs and VKA and provides practical recommendations for the management of acute bleeding situations.

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Preventive Strategies against Bleeding due to Nonvitamin K Antagonist Oral Anticoagulants

Cited by 6 publications

References 86 publications

NOACs: an emerging class of oral anticoagulants-a review article

NOACs: an emerging class of oral anticoagulants-a review article

Effect of tramadol and DOACs with special attention to dabigatran on concomitant use, on the risk of mayor bleeding using BIFAP database in Spain

Bleeding Risk, Management and Outcome in Patients Receiving Non-VKA Oral Anticoagulants (NOACs)

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