Types of Anticoagulants

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Anticoagulant Medications

Anticoagulants are types of drugs that manipulate the blood coagulation process. They inhibit thrombus formation, meaning that they prevent blood clots from forming too easily.1

 

Anticoagulants generally include non-vitamin K antagonist oral anticoagulants (NOACs), heparins and vitamin K antagonists (VKAs).1-4 All of these have different ways of working. Due to their pharmacological mode of action, the use of anticoagulants may be associated with an increased risk bleeding, which may result in post haemorrhagic anaemia.1-6

 

The signs, symptoms and severity of bleeding will vary according to the location (e.g. blood in urine, severe bruising) and degree or extent of the bleeding and/or anaemia. Your doctor will work out which anticoagulant is right for you based on the indication and the presence of any other medical conditions.1,5,6

 

All licensed anticoagulants deliver a positive benefit–risk profile. Although all anticoagulants can increase the risk of bleeding, strategies are available to reduce or stop bleeding.4

 

Vitamin K antagonists (e.g. warfarin, coumarins)

VKAs like warfarin are a group of substances that reduce blood clotting by reducing the action of vitamin K.7

 

VKAs come in tablet form and are taken orally. If you take VKA, you will need a specific blood test that measures the ability of your blood to clot with the use of the international normalised ratio, more commonly called INR.7

 

If your INR is too high, your dose of VKA may need to be reduced to lower your risk of excessive bleeding.7 Your doctor will determine the cause of the fluctuation and advise you if your medication or lifestyle habits may need to change. Your doctor will also tell you if your VKA dose needs to change.

 

If your INR is too low, your dose of VKA may need to be increased to lower your risk of clotting.7 Your doctor will tell you if your dose of VKA needs to change.

 

You may also find the following advice helpful in maintaining the right dose for you:7

 

  • Diet: Try to keep your diet consistent. Sudden changes in your food intake might mean that your dose will need to be adjusted. As always, please check with your healthcare professional to monitor any changes that may occur

 

  • Alcohol: Avoid excessive drinking. Please check with your healthcare professional for recommendations that are suitable for you

 

  • Medications: Changes in medication can also alter the effectiveness of VKAs. When one drug alters the effect of another, this is called a drug–drug interaction. Before you start or stop any medications you should check with your doctor or a healthcare professional. You should also try to take your VKA at the same time each day
Flow chart of VKA therapy and INR testing

Flow chart of VKA therapy and INR testing7

 

Non-VKA Oral Anticoagulants (NOACs)

Rivaroxaban

Rivaroxaban is a direct Factor Xa inhibitor oral anticoagulant. Rivaroxaban works by inhibiting Factor Xa, a protein that helps blood clots form. Rivaroxaban comes in a tablet form. Depending on the dose, you may be instructed to take your rivaroxaban tablets with our without food.8

 

Edoxaban

Edoxaban is a direct Factor Xa inhibitor oral anticoagulant. Edoxaban works by inhibiting Factor Xa, a protein that helps blood clots to form. Edoxaban comes in a tablet form. Edoxaban can be taken with or without food.9

 

Apixaban

Apixaban is also a direct Factor Xa inhibitor oral anticoagulant. Apixaban works by inhibiting Factor Xa, a protein that helps blood clots form. Apixaban comes in a tablet form. Apixaban tablets should be swallowed with water and can be taken with or without food.10

 

Dabigatran

By contrast to the NOACs listed above, dabigatran is a direct thrombin inhibitor. Dabigatran works by inhibiting the action of thrombin, a protein that helps blood clots form. Dabigatran comes in capsule form. Dabigatran capsules should be swallowed whole with a glass of water, with or without food. The capsule should not be opened and the capsule should be kept in the original packaging.11

 

Medications:

Tell your doctor or pharmacist that you are taking a NOAC before you start any new medicines or complementary therapy.8-11

 

Medical and dental procedures:

Tell your doctor or dentist that you are taking a NOAC well before any planned procedure, including operations in hospital, minor procedures at the doctor’s surgery and any dental procedures. Your NOAC therapy will be considered during the planning of your operation/procedure. Do not stop taking your NOAC unless instructed to by your doctor.8-11

 

Monitoring with NOACs:

Unlike vitamin K antagonists, NOACs do not require routine monitoring of exposure. It is important, however, before you start NOAC therapy that your doctor checks your kidney function. When on NOAC therapy, your doctor might decide to monitor your kidney function regularly. Your doctor will advise you about the frequency of the tests.8-11

 

Heparin

Heparin works immediately, preventing further clotting and is available as:2,4,5,6

  • Standard (unfractionated) heparin
  • Low molecular weight heparin (LMWH)

 

Standard (unfractionated) heparin can be administered either through an intravenous or subcutaneous injection or an intravenous infusion/drip.2 The dose varies from person-to-person and careful monitoring by your doctor/nurse is required.2

 

LMWHs, which include dalteparin,4 enoxaparin,5 and tinzaparin,6 are usually given as subcutaneous injections. LMWHs work differently from standard heparin. As in all anticoagulants, the risk of bleeding may be increased.2,4-6

References

Copyright © Bayer AG |

  • PP-M_RIV-ALL-0123-1

| Updated date 10/10/2022

La finalidad de este sitio web es proporcionar información al público internacional fuera de los EE. UU. y el Reino Unido.

Copyright © Bayer AG |

  • PP-M_RIV-ALL-0123-1

Updated date 10/10/2022

La finalidad de este sitio web es proporcionar información al público

internacional fuera de los EE. UU. y el Reino Unido.

Bayer Bayer

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