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[8] [9] Other side effects may include bleeding around the spine and allergic reactions. [8] Use is not recommended during pregnancy or breastfeeding. [1] [9] Use appears to be relatively safe in those with mild kidney problems. [9] Compared to warfarin it has fewer interactions with other medications. [12] It is a direct factor Xa inhibitor. [8]
The risk of bleeding is increased if used at the same time as other blood thinning drugs such as nonsteroidal anti-inflammatory drugs, antiplatelet drugs and heparin. [2] The blood thinning effects can be reduced if used at the same time as rifampicin and phenytoin , and increased with fluconazole .
An anticoagulant, commonly known as a blood thinner, is a chemical substance that prevents or reduces the coagulation of blood, prolonging the clotting time. [1] Some occur naturally in blood-eating animals, such as leeches and mosquitoes, which help keep the bite area unclotted long enough for the animal to obtain blood.
Four drugs from the class of direct Xa inhibitors are marketed worldwide. Rivaroxaban (Xarelto) was the first approved FXa inhibitor to become commercially available in Europe and Canada in 2008. [1] The second one was apixaban (Eliquis), approved in Europe in 2011 [2] and in the United States in 2012. [3]
When two drugs affect each other, it is a drug–drug interaction (DDI). The risk of a DDI increases with the number of drugs used. [1] A large share of elderly people regularly use five or more medications or supplements, with a significant risk of side-effects from drug–drug interactions. [2] Drug interactions can be of three kinds:
The mechanism of drug action and adverse drug reaction is either physiochemical property based and biochemical based. Adverse drugs reactions can be classified as either idiosyncratic (type B) or intrinsic (type A). Idiosyncratic toxicity is not dosage dependent and defy the mass-action relationship.
The significance of using drugs with optimal dose is lowering the occurrence of intolerable side effects, adverse reactions, and possible drug toxicity in patient's body. This increases the safe use of drugs and increases patient compliance with the therapy. [30] One of the examples is the use of calcium channel blocker and beta-blocker.
Warfarin – a coumarin – with brand name, Coumadin, is a prescription drug used as an anticoagulant to inhibit formation of blood clots, and so is a therapy for deep vein thrombosis and pulmonary embolism. [9] [10] [11] It may be used to prevent recurrent blood clot formation from atrial fibrillation, thrombotic stroke, and transient ...