Converting to Xarelto® in Daily Practice
Long-term anticoagulation is required to prevent stroke in patients with atrial fibrillation, to prevent venous thromboembolism (VTE) after orthopaedic surgery, and for the acute and continued treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE).
There are several new oral anticoagulant NOACs that offer patients and clinicians an alternative choice to the traditional methods used. In this article, the practical use of one of these, Xarelto®, is highlighted with a focus on how to convert from vitamin K antagonists (VKAs) and other anticoagulants such as low-molecular-weight heparins (LMWHs) to Xarelto® and vice versa.
Factors Determining Anticoagulant Use
The choice of anticoagulant depends upon a variety of factors including the individual circumstances of the patient and clinical experience. Two factors that may influence a decision to change from one anticoagulant to another are:
- the overall convenience of the anticoagulant therapy and the ease of administration for the patient
- the balance between the risks and the benefits of the different anticoagulants concerned.
Until recently VKAs were the only oral anticoagulants available for patients requiring long-
term anticoagulation to prevent stroke in atrial fibrillation (SPAF), LMWH for VTE prevention, and LMWH followed by VKA for DVT treatment and the continuous treatment of recurrent DVT and PE.
Today, while there are several new oral anticoagulants that have been tested in clinical trials, there is only one – Xarelto® – that is approved for SPAF, VTE prevention, and the treatment of acute DVT and long-term prevention of recurrent events.1
Converting from VKAs
Once a decision to convert a patient to Xarelto® has been made then the process required depends upon the current anticoagulant being used. Whatever anticoagulant is being used, it is important to ensure continuous anticoagulation in every clinical ►
Once-daily Dosing Across
Multiple Indications 1:00 min