LMWH and select direct oral anticoagulants can be used for anticoagulation therapy initiation on an outpatient basis.Ĭompared with vitamin K antagonists, direct oral anticoagulants have fewer overall drug-drug interactions, a comparable bleeding rate, a shorter half-life, and fixed dosing based on indication, drug interactions, and renal or hepatic function.Īmerican Academy of Family Physicians guidelines recommend the use of oral anticoagulants in patients with a CHADS2 score greater than 1 for the prevention of stroke in atrial fibrillation. Vitamin K antagonists, unfractionated heparin, low-molecular-weight heparin, and direct oral anticoagulants are commonly used for the prevention and treatment of systemic embolism associated with atrial fibrillation, stroke, and venous thromboembolism. BERNHEISEL, MD University of Cincinnati/The Christ Hospital, Cincinnati, OhioĪm Fam Physician. PATRICIA WIGLE, PharmD BRAD HEIN, PharmD and CHRISTOPHER R. Anticoagulation: Updated Guidelines For Outpatient Management

SUCRA Ranking of OACs for efficacy and safety stratified by renal function. In NVAF patients with moderate renal impairment, dabigatran-150 mg was the most effective treatment, and edoxaban-15 mg was the safest intervention. In NVAF patients with mild renal impairment, edoxaban-60 mg was the most effective treatment, and edoxaban-30 mg was the safest intervention. In NVAF patients with normal renal function, dabigatran-150 mg was the winner for the efficacy, and edoxaban-30 mg was the safest intervention.

Table 2 demonstrated the ranking of NOACs.

Antidote for vitamin k