North East and North Cumbria
ICS Formulary
 
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2 Cardiovascular system
02-08-02 Oral anticoagulants

County Durham and Darlington DVT Pathway Information

Tees Warfarin Guidelines for Primary Care


Warfarin
Formulary
  • 500 microgram, 1mg, 3mg & 5mg tablets Green Traffic Light.
  • 1mg/1ml oral suspension - - for use in paediatric patients on mechanical support using ventricular assistance devices, and for patients with mechanical heart valves or irregular heart rythms who have not been weaned Green Traffic Light.
Link  MHRA Drug Safety Update (July 2016): Warfarin: reports of calciphylaxis
Link  MHRA Drug Safety Update (June 2024): Warfarin: be alert to the risk of drug interactions with tramadol
Link  MHRA Drug Safety Update (Oct 2020): Warfarin and other anticoagulants: monitoring of patients during the COVID-19 pandemic

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Phenindione
Formulary

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Acenocoumarol Sinthrome®
Formulary
  • 1mg tablets

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Andexanet alfa Ondexxya®
Formulary

 

    • 200mg powder for solution for infusion

 

    • Approved for reversing anticoagulation from apixaban and rivaroxaban in adults with life-threatening or uncontrolled bleeding in line with NICE

 
Link  NICE TA697: Andexanet alfa for reversing anticoagulation from apixaban or rivaroxaban

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Apixaban
Formulary
  • Only approved for use in accordance with NICE guidance. 
  • In the absence of a specific clinical reason to select a particular DOAC, choose the most cost effective DOAC first. Rivaroxaban 'cost effective once daily choice for non-valvular AF' and Apixaban 'cost effective twice daily choice for non-valvular AF

 
Link  NICE TA245: Apixaban for the prevention of venous thromboembolism after total hip or knee replacement in adults
Link  NICE TA275: Apixaban for preventing stroke and systemic embolism in people with nonvalvular atrial fibrillation
Link  NICE TA341: Apixaban for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism
Link  MHRA Drug Safety Update Dec 2014: New oral anticoagulants apixaban (Eliquis▼), dabigatran (Pradaxa) and rivaroxaban (Xarelto▼)
Link  MHRA Drug Safety Update June 2019: Direct-acting oral anticoagulants (DOACs): increased risk of recurrent thrombotic events in patients with antiphospholipid syndrome
Link  MHRA Drug Safety Update June 2020: Direct-acting oral anticoagulants (DOACs): reminder of bleeding risk, including availability of reversal agents

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Dabigatran
Formulary
  • Only approved for use in accordance with NICE guidance. 

  • In the absence of a specific clinical reason to select a particular DOAC, choose the most cost effective DOAC first. Rivaroxaban 'cost effective once daily choice for non-valvular AF' and Apixaban 'cost effective twice daily choice for non-valvular AF
Link  MHRA Drug Safety Update Dec 2014: Dabigatran (Pradaxa): contraindicated in patients with prosthetic heart valve(s) requiring anti-coagulant treatment
Link  MHRA Drug Safety Update Dec 2014: New oral anticoagulants apixaban (Eliquis▼), dabigatran (Pradaxa) and rivaroxaban (Xarelto▼)
Link  MHRA Drug Safety Update June 2019: Direct-acting oral anticoagulants (DOACs): increased risk of recurrent thrombotic events in patients with antiphospholipid syndrome
Link  MHRA Drug Safety Update June 2020: Direct-acting oral anticoagulants (DOACs): reminder of bleeding risk, including availability of reversal agents
Link  MHRA Drug Safety update May 2023: Direct-acting oral anticoagulants (DOACs): paediatric formulations; reminder of dose adjustments in patients with renal impairment
Link  NICE TA157: Dabigatran etexilate for the prevention of venous thromboembolism after hip or knee replacement surgery in adults
Link  NICE TA249: Dabigatran for Stroke prevention in AF
Link  NICE TA327: Dabigatran etexilate for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism

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Edoxaban
Formulary
  • Only approved for use in accordance with NICE guidance. 

  • In the absence of a specific clinical reason to select a particular DOAC, choose the most cost effective DOAC first. Rivaroxaban 'cost effective once daily choice for non-valvular AF' and Apixaban 'cost effective twice daily choice for non-valvular AF
Link  MHRA Drug Safety Update June 2019: Direct-acting oral anticoagulants (DOACs): increased risk of recurrent thrombotic events in patients with antiphospholipid syndrome
Link  NICE TA354: Edoxaban for treating and for preventing deep vein thrombosis and pulmonary embolism
Link  NICE TA355:Edoxaban for preventing stroke/systemic embolism in non‑valvular atrial fibrillation

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Rivaroxaban
Formulary
  • 2.5mg tablets

 

  • Rivaroxaban co-administered with acetylsalicylic acid (ASA), is indicated for the prevention of atherothrombotic events in adult patients with coronary artery disease (CAD) or symptomatic peripheral artery disease (PAD) at high risk of ischaemic events.
  • Approved for use in accordance with NICE TA607
Link  MHRA Drug Safety Alert June 2020: Direct-acting oral anticoagulants (DOACs): reminder of bleeding risk, including availability of reversal agents
Link  MHRA Drug Safety Update Dec 2014: New oral anticoagulants apixaban (Eliquis▼), dabigatran (Pradaxa) and rivaroxaban (Xarelto▼)
Link  MHRA Drug Safety Update July 2019: Rivaroxaban (Xarelto▼): reminder that 15 mg and 20 mg tablets should be taken with food
Link  MHRA Drug Safety Update June 2019: Direct-acting oral anticoagulants (DOACs): increased risk of recurrent thrombotic events in patients with antiphospholipid syndrome
Link  MHRA Drug Safety update May 2023: Direct-acting oral anticoagulants (DOACs): paediatric formulations; reminder of dose adjustments in patients with renal impairment
Link  MHRA Drug Safety Update Oct 2018: Rivaroxaban (Xarelto▼) after transcatheter aortic valve replacement: increase in all-cause mortality, thromboembolic and bleeding events in a clinical trial
Link  NICE TA607: Rivaroxaban for preventing atherothrombotic events in people with coronary or peripheral artery disease

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Rivaroxaban
Formulary
    • 2.5mg, 10mg, 15mg & 20mg tablets
    • 1mg/1ml granules for oral suspension

        • approved for the treatment of VTE in children


    • Only approved for use in accordance with NICE guidance. 

    • In the absence of a specific clinical reason to select a particular DOAC, choose the most cost effective DOAC first. Rivaroxaban 'cost effective once daily choice for non-valvular AF' and Apixaban 'cost effective twice daily choice for non-valvular AF

 
Link  MHRA Drug Safety Update Dec 2014: New oral anticoagulants apixaban (Eliquis▼), dabigatran (Pradaxa) and rivaroxaban (Xarelto▼)
Link  MHRA Drug Safety Update July 2019: Rivaroxaban (Xarelto▼): reminder that 15 mg and 20 mg tablets should be taken with food
Link  MHRA Drug Safety Update June 2019: Direct-acting oral anticoagulants (DOACs): increased risk of recurrent thrombotic events in patients with antiphospholipid syndrome
Link  MHRA Drug Safety Update June 2020: Direct-acting oral anticoagulants (DOACs): reminder of bleeding risk, including availability of reversal agents
Link  MHRA Drug Safety update May 2023: Direct-acting oral anticoagulants (DOACs): paediatric formulations; reminder of dose adjustments in patients with renal impairment
Link  MHRA Drug Safety Update Oct 2018: Rivaroxaban (Xarelto▼) after transcatheter aortic valve replacement: increase in all-cause mortality, thromboembolic and bleeding events in a clinical trial
Link  NICE TA170: Rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults
Link  NICE TA256: Rivaroxaban for the prevention of stroke and systemic embolism in people with atrial fibrillation
Link  NICE TA261: Rivaroxaban for the treatment of deep vein thrombosis and prevention of recurrent deep vein thrombosis and pulmonary embolism
Link  NICE TA287: Rivaroxaban for treating pulmonary embolism and preventing recurrent venous thromboembolism
Link  NICE TA335: Rivaroxaban for preventing adverse outcomes after acute management of acute coronary syndrome

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