NPS on anticoagulants
August 7, 2014
NPS MedicineWise has advised
people not to stop taking
dabigatran (Pradaxa) without
speaking to their doctor, after
reports that safety information was
withheld (PD 05 Aug).
NPS said dabigatran, apixaban
and rivaroxaban were newer
anticoagulant medicines.
Warfarin had been the mainstay
of anticoagulant therapy for many
years and its anti-clotting effect
could be monitored with a blood
test (INR test), however there were
no equivalent tests for the newer
anticoagulants, NPS said.
If a patient started bleeding while
taking a newer anticoagulant, there
was currently no way to reverse it
quickly, NPS said.
NPS design and development
manager Aine Heaney said
while patients would not need
to have INR blood tests if they
had switched from warfarin to a
newer anticoagulant, it was just as
important to have regular checks
with a doctor to monitor health.
She said while there were risks
with every medication, it was
crucial patients did not stop taking
their oral anticoagulants without
medical advice, as this could risk
blood clots that could cause stroke.
NPS said the newer anticoagulants
were like any new drugs where the
longer term side effects were still
being understood.
Boehringer Ingelheim (BI) said
compared with warfarin, both
doses of Pradaxa had been shown
to significantly reduce intracranial
bleeding and risk of major bleeding
was reduced by 20% with Pradaxa
110mg bd.
“While there is currently no
specific antidote available for any
of the novel oral anticoagulants,
they all have much shorter halflives
than warfarin and there are
established measures and protocols
to reverse the anticoagulant effect
of Pradaxa and to manage bleeding
during an emergency situation.”
BI said it was working on an
antidote.
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