NOACs: an emerging class of oral anticoagulants-a review article
- PDF / 439,864 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 67 Downloads / 195 Views
Future Journal of Pharmaceutical Sciences
(2020) 6:95
REVIEW
Open Access
NOACs: an emerging class of oral anticoagulants-a review article Chithra Paul1* , Mable Baby1, Alfet Raju Anthraper1 and Krishnakumar K2
Abstract Background: NOACs, commonly known as novel oral anticoagulants, are the non-vitamin K antagonist oral anticoagulants which are relatively newer in the market. It has displaced vitamin K antagonists, notably warfarin, for many indications. These agents are dabigatran, rivaroxaban, apixaban, and edoxaban. Main body: The drugs are licenced to prevent stroke and also systemic embolism in patients on treatment for atrial fibrillation and prevent venous thromboembolism. Rivaroxaban and apixaban are approved for prophylaxis of thrombus following surgical hip or knee arthroplasty. The recent surveys reveal that use of NOACs has steeply increased due to its safety profile and convenience to use. Also, the studies have shown that NOACs have lesser bleeding complications and associated mortality in contrast to traditional anticoagulants. The upcoming years are known to be NOACs’ age due to the significant findings in this area. Conclusion: Therefore, a basic understanding on these drugs is highly recommended to provide a better service to the patients. This article aims to provide quick and brief information on the novel class of drugs. It equips an overview of NOAC and deals with the following areas: (i) pharmacology, (ii) laboratory methods, (iii) peri-operative management, (iv) advantages, (v) challenges, and (vi) future. Keywords: NOAC, VKA, Anticoagulants
Background Oral anticoagulants are drugs that are extensively used for the extended prevention and therapy of thromboembolism in veins and arteries [1]. Initially, vitamin K antagonists were the only feasible oral anticoagulants [2]. There is a substantial downside with the use of vitamin K antagonists (VKAs) such as increased risk of bleeding, narrow therapeutic index, individualized dosing based on INR, and many more [2, 3]. Novel oral anticoagulants (NOACs) resolved these issues to a remarkable extent. It is at least as effective as traditional anticoagulants and is convenient to administer as it is given as fixed doses without routine coagulation monitoring [1]. It has a predictable and consistent PK-PD * Correspondence: [email protected] 1 Department of Pharmacy Practice, St. James’ College of Pharmaceutical Sciences, St. James’ Hospital Trust Pharmaceutical Research Centre (DSIR recognized), Chalakudy, Kerala, India Full list of author information is available at the end of the article
profile [4]. NOACs include four drugs, of which, dabigatran was the first to be FDA approved in 2010. It is a direct thrombin inhibitor. Rivaroxaban, apixaban, and edoxaban fall under direct factor Xa inhibitors that were approved on 2011, 2014, and 2015, respectively [5].
Main text Pharmacological aspects of NOACs
Unlike VKAs, NOACs have more predictable PK-PD properties [4]. Due to this appreciable characteristic, NOACs are used at fixed doses without
Data Loading...
