Advantages And Disadvantages Of Rivaroxaban Vs Warfarin

Coumadin (non specific name: warfarin) is an anticoagulant, or blood diminishing drug, that is endorsed to numerous patients who are at danger for creating blood clusters that could bring about heart assaults or strokes. Warfarin is near the most astounding purpose recently and simultaneous investigations of medications that provoke ER visits and occurring an expansion in healing center based offices with the affirmation of patients. Anticoagulation treatment stances perils to patients and over and over prompts unfavorable solution events in light of complex dosing, fundamental ensuing watching, and clashing patient consistence. As a result, various patients who meet current evidence based principles for warfarin treatment are not being managed

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Stroke was defined as the sudden onset of a focal neurologic deficit in a location associated with the area of a major cerebral artery. The primary safety outcome was major hemorrhage and was defined as a reduction in the hemoglobin level of at least 20 g/L, transfusion of at least 2 units of blood, or symptomatic bleeding in a critical organ or area. Results were calculated using the Cox proportional-hazards modeling. Systolic embolism or stroke occurred in 199 patients receiving warfarin, 182 patients receiving 110 mg of dabigatran twice daily, and in 134 patients receiving dabigatran 150 mg twice daily. Major bleeding events occurred in 3.36% of participants per year with warfarin, 2.71% per year in patients that received 110 mg of dabigatran, and 3.11% per year in those receiving 150 mg of dabigatran. From calculated data, results revealed that dabigatran administered at a dose of 110 mg twice daily was non-inferior to that of warfarin. Lower rates of stroke were associated with dabigatran administered at a dose of 150 mg twice daily compared with that of warfarin. For safety, it was concluded that the risk of bleeding was lowest with dabigatran 110mg twice daily, and was similar between dabigatran 150 mg twice daily and

Other outcomes were myocardial infarction, ischemic stroke, systemic thrombosis, venous thrombosis in other areas of the body besides the legs, and even death. The patients underwent assessment either in the clinic or by telephone at days 30, 90, 180, 270, and 360. This study was consistent with other studies in the fact that the use of rivaroxaban reduced the risk of recurrent venous thromboembolism by about 70%. Rivaroxaban was found to be more effective than aspirin for the prevention of recurrent venous thromboembolism and was associated with a smaller risk of bleeding. The primary outcome occurred in 17 out of the 1,107 individuals who received 20 mg of rivaroxaban and in 13 out of the 1,127 individuals who received 10 mg of rivaroxaban. This was compared to 50 out of the 1,131 individuals who received aspirin once a day. Rates of bleeding were 0.5% in individuals who received 20 mg of rivaroxaban, 0.4% in individuals who received 10 mg of rivaroxaban, and 0.3% in individuals who received aspirin. For patients with venous thromboembolism who continued anticoagulation the risk of a repetitive event was lower with rivaroxaban at both 20 mg and 10 mg of treatment doses rather than with

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Therapeutic Uses Warfarin is used most often for long-term prophylaxis of thrombosis. “Specific indications are (1) prevention of venous thrombosis and associated pulmonary embolism, (2) prevention of thromboembolism in patients with prosthetic heart valves, and (3) prevention of thrombosis during atrial fibrillation.”(Lehne, 2010, p. 605). Warfarin is the oral anticoagulant of choice for these indications. The drug has also been used to reduce the risk of recurrent transient ischemic attacks (TIA) and recurrent myocardial infarction (MI).(Lehne, 2010).

Atrial fibrillation is the most frequent cardiac arrhythmia. There has always associated risk of clot formation and embolization that can lead to ischemic stroke. A large number of these ischemic events could be prevented by timely anticoagulation. Warfarin has been used for decades for this purpose, but there are many problems for the patients due to warfarin therapy like there is continuous need of INR monitoring, many food and drug interactions of the drug, late onset of action and risk of major bleeding. Anticoagulation with the Novel oral anticoagulants e.g. Dabigatran, rivaroxaban, apixaban, endoxaban led to similar or even lower rates of ischemic stroke and major bleeding compared to an adjusted dose of warfarin (INR 2-3) in patients

Warfarin can lead to severe bleeding risks which may lead to fatality. Those who are over the age of 65 may be more sensitive to warfarin. ( cite)

A New Generational Anticoagulant For many year’s patients with atrial fibrillation have been treated with anticoagulants such as Warfarin to prevent strokes and embolisms. Unfortunately, Warfarin must be closely monitored and that is an irritant for some patients. In October 2010, the FDA approved a new generational anticoagulant drug called Dabigatran

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Other drugs of research include the anticoagulant warfarin, the antiretroviral agent abacavir, and the antibody trastuzumab. All these drugs have genetic variant forms that can affect the effectiveness of pharmacological therapy. Warfarin is a vitamin K antagonist used to prevent thromboembolic disorders.

However, 32 patients (42.1%) were using Warfarin prior to Dabigatran. The prior use of Warfarin was significantly associated with bleeding (p= 0.014), hospitalization (p< 0.001) , and death (p= 0.007). This was more prominent in older patients > 75 years, and in patients with comorbid conditions. The rate of hospitalization in the cohort for fifty one patients was (67.1%). There were no significant associations between hospitalization, and the tested variables. The levels of hemoglobin (taken as mean of 3 values) ≥130 versus 65 years. The causes of death in patients using Dabigatran were not relevant to the drug as per the death certificates (p <0.611), [Table 3]. The reported causes of death were attributed to TE, cardiac, and respiratory arrests. The only variables that were significantly associated with death were TE [p= 0.024, (95% CI for B= 0.44 - 0.586)], and blood transfusion [p= 0.011, (95% CI for B=0.085 - 0.639];

The pharmacological intervention includes the use of low molecular weight heparin (LMWH) and low-dose unfractionated heparin (LDUH). A finding of the study suggests that there is a significant reduction of VTE (13%) using thrombo-prophylaxis than without using any thrombo-prophylaxis (27%) and the single use of LDUH decreases the case with 15% (McNamara, 2014, pp.645). Furthermore, the study elaborates the use of aspirin could be an intervention to minimize the VTE but there is a chance of gastrointestinal bleeding. Thus, aspirin and other antiplatelet drugs are less effective methods to reduce VTE. Moreover, the pharmacological method is not effective in certain case that is associated with bleeding disorder. Therefore, there is a need of non-pharmacological preventive

Warfarin is a prescription medicinal drug used to save you harmful blood clots from forming or developing large. useful blood clots prevent or prevent bleeding, but dangerous blood clots can reason a stroke, coronary heart attack, deep vein thrombosis, or pulmonary embolism. because warfarin interferes with the formation of blood clots, it's far referred to as an anticoagulant. Many humans check with anticoagulants as “blood thinners”; but, warfarin does now not thin the blood but rather reasons the blood to take longer to form a clot. Warfarin decreases the body’s capability to form blood clots through blocking the formation of diet k–established clotting elements. diet okay is needed to make clotting elements and prevent bleeding. therefore,

The Medications that can cause interactions include anticoagulants, probenecid, bisphosphonates, angiotensin-converting enzyme (ACE) inhibitors, anticoagulants (Warfarin), antiplatelet medicines (Clopidogrel), aspirin, corticosteroids (Prednisone), heparin, other NSAIDs (Ibuprofen), Rivaroxaban, or Selective Serotonin Reuptake Inhibitors (SSRIs) (Fluoxetine) due to the risk of stomach bleeding may be increased. Bisphosphonates (Alendronate), Cyclosporine, Hydantoins (Phenytoin), Lithium, Methotrexate, Quinolones (Ciprofloxacin), Sulfonamides (Sulfamethoxazole), and Sulfonylureas (Glipizide) side effects may be increased by Naproxen. The effectiveness of Angiotensin-converting enzyme (ACE) inhibitors (Enalapril), Beta-blockers (Propranolol), or diuretics (Furosemide, Hydrochlorothiazide) may be decreased by Naproxen (Lexi-Comp,