Risks and Benefits of Warfarin Versus New Oral Anticoagulant Drugs
Warfarin had been the outpatient anticoagulation drug available for atrial fibrillation, hypercoagulable states, and deep vein thrombosis (DVT) since mid-1950s. Now we have NOACs. The pros versus the cons of NOACs, compared to warfarin, include:
1) No laboratory monitoring
2) Few dietary and medication interactions
3) Short duration of action
4) Less comorbidities and improved mortality rate.
1) NOACs are expensive
2) If a dose is missed, drug levels decrease quickly
3) Antidotes are not widely available
4) Increased adverse events when used in patients with renal disease
5) Some NOACs require twice-daily dosing.