Oral Anticoagulant Research Paper

COMPARISON OF WARFARIN AND THE NEW ORAL ANTICOAGULANTS any medication should be efficacious. When compared with warfarin, the new oral anticoagulants have a faster onset and expected pharmacokinetics (Table 2).1 also , routine anticoagulation monitoring is unwanted , and these agents are at least as efficacious as warfarin. Table 2
Pharmacokinetic Properties of Recently Approved Oral Anticoagulants Rivaroxaban (Xarelto)1
Mechanism of action Direct factor Xa inhibitor
Oral bioavailability 60%–80%
Volume of distribution 50 L
Half-life 5–13 hours
Metabolism/elimination 33% renal; 66% hepatic
Protein binding > 90%
Data from prescribing information for rivaroxaban,1

Warfarin work as anticoagulation by blocking the synthesis of vitamin K–dependent

It is also approved for handling of VTE and PE and VTE prophylaxis in patients suffer from knee or hip alteration. For patients with AF, rivaroxaban 20 mg once daily should be taken with food. Because of the drug’s partial renal excretion, the dose should be minimize to 15 mg once daily in patients with a Creatinine clearance rate is 15 to 50 mL/minute .
The major disadvantage effect of rivaroxaban were related to bleeding and its happened at rates same to those of warfarin in clinical trials. Non-hemorrhagic adverse drug action reported at a rate of 5% or more included peripheral edema, dizziness, nasopharyngitis, cardiac failure, bronchitis, dyspnea, and diarrhea, which happened at rates like to those receiving warfarin1
Interruption of therapy should be minimized to reduce the danger of thrombosis. Anticoagulation effectiveness may be extended in patients with renal impairment because of partial renal clearance (see Table 2)1
There is no particular antidote for rivaroxaban. It is not dialyzable, because its protein binding is nearly 95%.
Clinical Trials and

The danger of main bleeding was same to be between rivaroxaban and warfarin, although the happening of intracranial and deathly bleeding was higher in the warfarin arm. average of major and non-major clinically relevant bleeding were 14.9% annually with rivaroxaban and 14.5% annually with warfarin (HR, 1.03; 95% CI, 0.96–1.11; P = 0.44). The average of hemorrhagic stroke was significantly less in the rivaroxaban (HR, 0.59; 95% CI, 0.37–0.93; P = 0.024), as was the average of intracranial bleeding case (0.5% vs. 0.7% annually; HR, 0.67; 95% CI, 0.47–0.94; P = 0.019).
The cost of rivaroxaban, in comparison with warfarin, for stroke banning in AF was evaluated in a base-case analysis study. The examiner progress a Markov model by a U.S. payer/Medicare perspective and measured the cost in 2011 U.S. dollars. They found that patients treated with rivaroxaban still live for a rate of 10.03 QALYs (quality-adjusted life year) at a lifetime treatment cost of $94,456, in comparison with patients taken warfarin lived for a rate of 9.81 QALYs and incurred a cost of $88,544. The incremental cost-active ratio was $27,498 per QALY. Rivaroxaban is a cost-effective alternative to warfarin, by the mentioned willingness-to-pay threshold of