[The new antithrombotics in 2009]

Presently used anticoagulant drugs include parenterally administered compounds (unfractionated heparin, low-molecular-weight heparins and fondaparinux) and oral vitamin K antagonists. Among the new drugs that are still in phase III clinical development in most indications, the oral factor Xa inhibitor rivaroxaban and the oral direct thrombin inhibitor dabigatran etexilate are expected to be soon introduced on the Swiss market for thromboprophylaxis following major orthopedic surgery. Even though aspirin remains the major antiplatelet agent, the questions of combination of antiplatelet agents and loading dose administration patterns of clopidogrel have been intensively studied in recent years. Among the numerous compounds in clinical development, the new thienopyridine prasugrel is certainly the one that is at the most advanced stage.