Data di Pubblicazione:
2017
Citazione:
Old and new oral anticoagulants : food, herbal medicines and drug interactions / A. Di Minno, B. Frigerio, G. Spadarella, A. Ravani, D. Sansaro, M. Amato, J.P. Kitzmiller, M. Pepi, E. Tremoli, D. Baldassarre. - In: BLOOD REVIEWS. - ISSN 0268-960X. - (2017 Feb 05). [Epub ahead of print] [10.1016/j.blre.2017.02.001]
Abstract:
The most commonly prescribed oral anticoagulants worldwide are the vitamin K antagonists (VKAs) such as warfarin. Factors affecting the pharmacokinetics of VKAs are important because deviations from their narrow therapeutic window can result in bleedings due to over-anticoagulation or thrombosis because of under-anticoagulation. In addition to pharmacodynamic interactions (e.g., augmented bleeding risk for concomitant use of NSAIDs), interactions with drugs, foods, herbs, and over-the-counter medications may affect the risk/benefit ratio of VKAs. Direct oral anticoagulants (DOACs) including Factor Xa inhibitors (rivaroxaban, apixaban and edoxaban) and thrombin inhibitor (dabigatran) are poised to replace warfarin. Phase-3 studies and real-world evaluations have established that the safety profile of DOACs is superior to those of VKAs. However, some pharmacokinetic and pharmacodynamic interactions are expected. Herein we present a critical review of VKAs and DOACs with focus on their potential for interactions with drugs, foods, herbs and over-the-counter medications.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Co-morbidities; Direct anticoagulant drugs; Loss of efficacy; Patients characteristics; Therapeutic context; Thrombotic/bleeding events; Toxicity; Warfarin
Elenco autori:
A. Di Minno, B. Frigerio, G. Spadarella, A. Ravani, D. Sansaro, M. Amato, J.P. Kitzmiller, M. Pepi, E. Tremoli, D. Baldassarre
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