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Switching between oral anticoagulants

Kristen M Strasser1, Abdulraheem Qasem, Sheshadri Madhusudhana

  • 1University of Missouri-Kansas City, Kansas City, MO. Strasserk@umkc.edu.

Hospital Practice (1995)
|September 26, 2014
PubMed

Insights

Switching between oral anticoagulants like warfarin, dabigatran, rivaroxaban, and apixaban is now possible. This article details reasons for switching and conversion methods for these anticoagulants.

Area of Science:

  • Pharmacology
  • Cardiology
  • Internal Medicine

Background:

  • Warfarin was the sole oral anticoagulant in the US until novel agents emerged.
  • Novel oral anticoagulants (NOACs) include dabigatran, rivaroxaban, and apixaban.
  • Switching between these anticoagulants is now a clinical consideration.

Purpose of the Study:

  • To review the characteristics of four US-approved oral anticoagulants.
  • To outline the indications for switching between these anticoagulant agents.
  • To describe established methods for converting between oral anticoagulants.

Main Methods:

  • Comprehensive literature search of original trial data.
  • Review of recent expert consensus articles.
  • Synthesis of current recommendations for anticoagulant switching.

Main Results:

  • Detailed comparison of the four main oral anticoagulants.
  • Identification of clinical scenarios necessitating anticoagulant switching.
  • Summary of practical conversion strategies between agents.
  • Brief overview of emerging oral anticoagulants.

Conclusions:

  • Understanding anticoagulant characteristics is crucial for informed switching.
  • Specific clinical factors guide the decision to switch anticoagulants.
  • Established protocols facilitate safe and effective conversion between agents.

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