Quiz
When considering a switch from warfarin to a NOAC, all the following factors should be considered a potential advantage, except:
A. No need for routing lab monitoring.
B. Lower risk of gastrointestinal bleeding.
C. Fewer drug interactions.
D. Lower rates of intracranial bleed and hemorrhagic stroke.
The correct answer is B. NOACs have been associated with lower risk of intracranial bleed and hemorrhagic stroke but not gastrointestinal bleed. Routine lab monitoring is not necessary during their use and they are associated with fewer drug interactions compared to warfarin.
Key Points
- NOACs represent a clear advancement in our anticoagulation armamentarium.
- Potential advantages of their use include lower rates of intracranial bleed and hemorrhagic strokes, fewer drug or food interactions, and lack of need for routing lab monitoring.
- Potential disadvantages of their use include increased rates of gastrointestinal bleed with some agents, general lack of availability of reversal agents, higher drug cost, unsuitability in patients with poor medication compliance, and lack of efficacy data in certain patient populations.
- Decision to switch from warfarin to a NOAC should thoroughly consider its pros and cons, clinical factors, and patient preferences.