Beyond warfarin: the new generation of oral anticoagulants and their implications for the management of dental patients.
Warfarin has been the primary anticoagulant drug used in the USA for more than 50 years. However, 2 novel types of oral anticoagulants have recently been approved for use in the USA. These are direct thrombin inhibitors (e.g., dabigatran etexilate) and factor Xa inhibitors (e.g., rivaroxaban). Dental health care providers may soon encounter patients who are being prescribed these medications. This article describes the pharmacologic properties and medical uses of these new oral anticoagulants. Also discussed are implications for the management of dental patients being treated with these new oral anticoagulants, including potential interactions with drugs commonly used or prescribed in the course of dental treatment.
Division of Oral Medicine, Department of General Dentistry and Oral Medicine, School of Dentistry, University of Louisville, Louisville, Kentucky, USA. john.firriolo@louisville.edu
F John
FJ
Firriolo
Wendy S
WS
Hupp
D000284:Administration, Oral; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D000991:Antithrombins / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D001562:Benzimidazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D001682:Biological Availability; D001780:Blood Coagulation Tests; D000069604:Dabigatran; D004347:Drug Interactions; D065427:Factor Xa Inhibitors; D006207:Half-Life; D006801:Humans; D009025:Morpholines / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D009294:Narcotics / Q000009:adverse effects; D006472:Oral Hemorrhage / Q000209:etiology; D019647:Oral Surgical Procedures / Q000009:adverse effects; D019106:Postoperative Hemorrhage / Q000209:etiology; D000069552:Rivaroxaban; D013876:Thiophenes / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D014859:Warfarin / Q000009:adverse effects / Q000494:pharmacology; D015091:beta-Alanine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D000991:Antithrombins; D001562:Benzimidazoles; D065427:Factor Xa Inhibitors; D009025:Morpholines; D009294:Narcotics; D013876:Thiophenes; D015091:beta-Alanine; D014859:Warfarin; D000069552:Rivaroxaban; D000069604:Dabigatran