New/Novel Oral Anticoagulant Resource Page
New/Novel Oral AntiCoagulant = NOAC
The University of Utah Health Care Thrombosis Service is committed to assisting providers in safely and appropriately incorporating new/novel oral anticoagulant agents (NOACs) into practice and to providing health care professionals and patients with new agent related education.
To aid clinicians in the safe and appropriate use of the new oral anticoagulants we have created this page which provides guidelines for clinical use and management of the new oral anticoagulants, provider and patient education materials, relevant peer-reviewed articles, and information about requesting Thrombosis Service consultation if you are considering NOAC therapy and would like assistance.
The information on this page provides guidance specific to Dabigatran (Pradaxa®) and Rivaroxaban (Xarelto®), plus information applicable to the group of novel oral anticoagulants, to include a comparison of agents.
We have a pre-existing Dabigatran (Pradaxa®) resource page which will remain on this website, in addition to the guidance documents related to dabigatran that are provided here (http://healthcare.utah.edu/thrombosis/dabigatran.html).
Education
For Patients:
- Patient Education: Dabigatran (only)
- Patient Education: Rivaroxaban (only)
- Patient Education: ALL Novel (New) Oral Anticoagulants
For Providers:
Documents
- Provider Education: Dabigatran (only)
- Provider Education: Rivaroxaban (only)
- Provider Education: Novel Oral Anticoagulants
- Novel Oral Anticoagulant Comparison
- RN Education Handout: Dabigatran (only)
- Internal Medicine Grand Rounds: "Anticoagulant Therapy Update 2011" (View Video) (View Video for CME Credit)
- Dabigatran (Pradaxa®) Pharmacy Grand Rounds PowerPoint Presentation
- Dabigatran (Pradaxa®) Clinical Education and Council PowerPoint Presentation
Clinical Guidance
Screening & Follow-up
- Clinical Screening Checklist for Dabigatran
- Clinical Screening Checklist for Warfarin-Dabigatran-Rivaroxaban
- Clinical Follow-up for Novel Oral Anticoagulants
Guidelines:
- NOAC Medication Use Guideline
- NOAC Periprocedural Guideline
- NOAC Laboratory Monitoring
- NOAC Reversal and Bleeding Management
Consultation
- Consultation Information
- Request for Consultation
- Consultation Follow-up Letter to Providers
- Switch Consideration Letter
- Physician Follow-up Letter Regarding Change in Therapy (Redwood Clinic)
- Physician Follow-up Letter Regarding Change in Therapy (Thrombosis Center)
Suggested Reading - NOAC Articles:
- Ageno W, Gallus AS, Wittkowsky A, Crowther M, Hylek EM, Palareti G. Oral anticoagulant therapy: Antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012;414:e44S-e88S.
- You JJ, Singer DE, Howard PA, Lane DA, Eckman MH, Fang MC, et al. Antithrombotic therapy for atrial fibrillation: Antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141; e531S-e575S.
- Connolly SJ, et al. for the RE-LY Study Group. Dabigatran versus Warfarin in Patients with Atrial Fibrillation. N Engl J Med 2009;361:1139-1151.
- Wallentin L, et al, on behalf of the RE-LY Investigators. Efficacy and Safety of Dabigatran Compared with Warfarin at Different Levels of International Normalized Ratio Control for Stroke Prevention in Atrial Fibrillation: An Analysis of the RE-LY Trial. Lancet 2010;376:975-983.
- van Ryn J, et al. Dabigatran Etexilate - A Novel, Reversible, Oral Direct Thrombin Inhibitor: Interpretation of Coagulation Assays and Reversal of Anticoagulant Activity. Thromb Haemost 2010;103:1116-1127.
- Douketis JD. Pharmacologic Properties of the New Oral anticoagulants: A Clinician-oriented Review with a Focus on Perioperative Management. Curr Pharm Des 2010;16:3436-3441.
- Pradaxa® Package Insert
- Xarelto Manufacture Prescribing Information
- Turpie AG, et al. Rivaroxaban for the prevention of venous thromboembolism after hip or knee arthroplasty. Pooled analysis of four studies. Thromb Haemost 2011;105:444-53.
- Patel MR, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 2011;365:883-91.
- Abrams PJ, Emerson CR. Rivaroxaban: A novel, oral, direct factor Xa inhibitor. Pharmacotherapy 2009;29:167-81.
- Lindhoff-Last E, et al. Assays for measuring rivaroxaban: Their suitability and limitations. Ther Drug Monitor 2010;32:673-9.
- Bauer KA. Reversal of antithrombotic agents. Am J Hematol 2012; Epub ahead of print.
Dabigatran (Pradaxa®) Website
Rivaroxaban (Xarelto®) Website
Please note: The content provided on this page is for general education and informational purposes only and is not intended to substitute the care and advice provided by a licensed clinician. Please consult your primary care physician directly for all individual care decisions.
