The oral anticoagulant tablet, Xarelto® (rivaroxaban), has today been recommended in final, published guidance by the National Institute for Health and Clinical Excellence (NICE) for the treatment of deep vein thrombosis (DVT) and the prevention of recurrent DVT and PE following an acute DVT in adults.
DVT is a blood clot that forms in a deep vein, usually the leg, which can partially or fully block the flow of blood. If left untreated, DVT blood clots can break and travel toward the lungs and cause a PE – a blockage of one or more vessels in the lung, which can be rapidly fatal.
Today’s announcement follows the recent publication of NICE Clinical Guidelines on the management of venous thromboembolism (VTE), which recognise that the failure to adequately detect and treat VTE can result in serious patient outcomes, including death.
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Some will not prescribe and at the moment a minority will. there will soon be new commissioning groups replacing PCTs and we are working with some of them to look at patient choice or anticoagulation. So warfarin, new orals, self-testing should all be on the agenda
our understanding is that the companies are working on this. However the new drugs have a much shorter half life. This means that if you stop taking them they are only in your body for about 12 to 15 hours, unlike warfarin which is about 37 hours.
The antidote is in clinical testing and is known as andexanet alfa. Should be approved fairly soon, according to my recently-retired pharma expert friend
In the US now that Xarelto has an indication for PE and DVT the choice will be made by primary care doc with their patients. See this FP's discussion at drpullen.com/xareltovswarfa...
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