Background The expectations raised by the new oral anticoagulants (OACs) have led some experts to view them as the ideal substitute for anti-vitamin K.
Purpose To analyse the use of dabigatran and rivaroxaban in a Spanish tertiary hospital since their inclusion in the formulary to date.
Materials and Methods The period of study was January 2010–September 2012. We carried out a study on the patients prescribed either of the two new OACs included in the formulary. A data collection sheet was designed in which the parameters recorded were: gender, age, indication and observations (if any adverse reaction had been described).
Results In the period January 2010-September 2012, a total of 86 patients (38% male) were treated with rivaroxaban, with a mean age of 66 (21–91)years old; whereas in the period December 2011–September 2012 (dabigatran was included later in the formulary), 55 patients (60% male), with a mean age of 74 (45–93) years, were treated with dabigatran. 84 out of the 86 patients treated with rivaroxaban received it in prophylaxis after having undergone knee or hip replacement. Nevertheless, dabigatran was used mostly in non-surgery patients, only 2 out of the 55 patients were traumatology patients.
Only one minor bleed was reported in one patient diagnosed with atrial fibrillation and treated with dabigatran, and it should be taken into account that this patient exhibited thrombocytopenia at the time the bleeding occurred. No other adverse effects related to the administration of these drugs were found.
To date, the price of these new OACs is more than ten times higher than anti-vitamin K.
Conclusions Despite the fact that the new OACs have been shown as a good option compared to anti-vitamin K, their use in our hospital is still moderate, for two main reasons: their high cost and the uncertainty about their management in critical situations.
No conflict of interest.
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