Anticoagulants are prescribed to help prevent blood clots in those at risk of developing them, including people with artificial heart valves or atrial fibrillation, those who have had a heart attack or stroke and those at risk of deep vein thrombosis or pulmonary embolism. Warfarin is the most commonly prescribed anticoagulant but requires regular coagulation monitoring and has numerous interactions with other drugs and food. Four new oral anticoagulants (NOACs) are also available in the UK, which have a more predictable therapeutic response, a more rapid onset of action, fewer drug interactions and no requirement for regular coagulation monitoring. On this page you will find news stories and articles relating to anticoagulants, which cover the development and licensing of NOACs and the management of patients taking both NOACs and warfarin. Our research article also examines the impact of a pharmacist-led anticoagulant review clinic for high-risk patients.
CPD and research articles
Heparin is widely used for thromboprophylaxis or as a treatment in many clinical situations, however, it can cause serious adverse effects. Heparin-induced thrombocytopenia (HIT), an immune-mediated adverse drug reaction, is associated with high morbidity and mortality if undiagnosed.
News and events
A “notable number” of medication errors involving direct oral anticoagulants occurred in the first quarter of 2019, according to the National Pharmacy Association’s Medication Safety Officer update for April–June 2019.
Compared with patients taking warfarin monotherapy, those taking aspirin and warfarin were at a higher risk of a bleeding event but the rate of thrombotic events was similar.
Pharmacists should manage medicines during transitions of care to improve medicines safety, NHS Improvement proposes
A nominated pharmacist should be designated to manage medicines during patient transitions between all settings, NHS Improvement has proposed as part of a consultation on medicines safety.
People with atrial fibrillation who have dementia are less likely to receive oral anticoagulants (OACs) than those without cognitive impairment, research has shown.
Direct oral anticoagulants carry lower risk of major bleeding versus warfarin, data showSubscription
Research from primary care suggests apixaban may be the safest of the direct oral anticoagulants overall.
GP prescribing of anticoagulants for the treatment of patients with atrial fibrillation and a high risk of stroke more than doubled between 2000 and 2016, from 35.4% to 75.5%, according to research published in July 2018.
Results from an ongoing trial of 228 patients with acute major bleeding show that patients taking andexanet experienced a reduction in anti-FXa activity.
The risk of both stroke and haemorrhage increases as chronic kidney disease progresses, which can complicate the decision on whether to begin anticoagulation in those with concomitant atrial fibrillation.
Community pharmacy is “ideally placed” to provide a safe anticoagulation service for patients needing warfarin monitoring
A Norwegian cohort study finds that warfarin has broad anticancer potential, which could have implications for medication choice for patients needing anticoagulation
A study in The New England Journal of Medicine has shown no significant difference in results following pharmacomechanical therapy for deep-vein thrombosis
Antithrombotic agents associated with haematuriaSubscription
Antithrombotic medications increase risk of complications linked to blood in the urine
Patients receiving genotype-guided dosing of warfarin were less likely to have a major bleed or die than patients whose dosing was clinically guided.
Anticoagulants could cut the risk of dementia for patients with atrial fibrillation, researchers find
Oral anticoagulants are associated with a significant reduction in the risk of dementia in patients with atrial fibrillation (AF), according to a study published in the European Heart Journal.
Treating venous thromboembolism with direct oral anticoagulants creates no greater risk of major bleeding or death in the first 90 days of treatment compared with warfarin.
A new community pharmacy oral anticoagulant safety audit, developed by the NHS’s Specialist Pharmacy Service (SPS), has been endorsed by the Royal Electronicjuice.
Researchers find that idarucizumab effectively counteracts the workings of anticoagulant dabigatran in emergency situations.
Cash-strapped clinical commissioning groups (CCGs) are increasingly pushing GP practices to prescribe and monitor specialist drugs that are outside their area of expertise, without paying for the extra work.
Results reinforce the importance of starting anticoagulation treatment as soon as possible after diagnosis, researchers conclude.
Study results show that choosing apixaban over warfarin could reduce the risk of anticoagulation-related intracranial haemorrhage.
Among patients with nonvalvular atrial fibrillation, study data show the use of dabigatran rather than warfarin was associated with a lower risk of osteoporotic fracture.
Genotype-guided dosing improves safety of warfarin Subscription
Older adults who received a genotype-guided dose of warfarin via a web application were less likely to experience adverse effects compared with clinical dosing, trial results show.
Atrial fibrillation patients not receiving guideline-recommended drugs to reduce stroke riskSubscription
Retrospective data analysis results show that the 16% of patients who were given anticoagulant prior to stroke showed reduction in stroke severity, lower odds of mortality and better functional outcomes.
Rivaroxaban is as safe as aspirin and more effective at preventing recurrent venous thromboembolism (VTE) in patients who were in equipoise for continued anticoagulants, a study shows.
Patients prescribed antithrombotic drugs, such as low-dose aspirin, clopidogrel or warfarin, are at increased risk of having a subdural haematoma, research published in JAMA has confirmed.
Analysis of ‘real-life’ data comparing newer direct oral anticoagulants with warfarin has identified adverse drug reactions (ADRs) ‘not previously associated’ with the new treatments, including hip fracture.