You will find a comparison of warfarin and NOACS below. Both medication classes are frequently used in practice and a familiarity with these agents is necessary for any practicing pharmacist. A huge thank you to Aisha Shokoya for putting the majority of this table together.
If you notice something that should be added or changed, please feel free to comment below!
|Cost||Low Cost & widely available||High Cost|
|No adjustment necessary for renal impairment||Dose adjustments necessary or contraindications for renal impairment|
|Hepatic Impairment Dose Adjustment||Must make dose adjustments, but INR monitoring will guide therapy||No dose adjustments but not recommended in severe cases|
|Monitoring||Frequent monitoring of INR with associated cost burdens||INR not required|
|Drug Interactions||Many interactions with food & drugs||Less interactions; Rivaroxaban interacts with CYP3A4 and P-glycoprotein inhibitors. Dabigatran is affected by P-glycoprotein inducers & inhibitors|
|Reversal agents||Vitamin K||Only one agent available for dabigatran only (idarucizumab)|
|Patients with cardiac valve replacements||Only anticoagulant for patients with cardiac valve replacements||No use in patients with cardiac valve replacements|
|Adherence Assessment||INR can help assess adherence, once daily dosing nice||BID dosing for some, No lab monitoring for adherence|
|Dietary restrictions||Must have consistent level of vitamin K uptake||None, except Rivaroxaban should be taken with food for DVT prophylaxis of atrial fibrillation|
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