They have few (known) drug interactions and are not affected by diet (as opposed to Warfarin).These molecules bring with them the message of predictable, orally administered anticoagulation that does not need daily monitoring. Oral Xa inhibitors can be recognized because their names end with ‘aban’. Read more to learn about the various oral Xa inhibitors. These drugs have been developed artificially since the 1990’s based on various naturally occurring compounds found in a Mexican leech and in a soft shell tick. The advent of a subcutaneous factor Xa inhibitor ( fondaparinux) heralded the development of oral Xa inhibitors. However even predictable clinical effects of subcutaneous low molecular weight heparin are encumbered by the need for injections. Subcutaneous options in the form of low molecular weight heparin that have proven even more useful for prevention and treatment of venous thromboembolism in real life situations in comparison to unfractionated heparin have by now been long in use. As intravenous medication has obvious drawbacks, other means of administration of anticoagulation are constantly being sought. Substitutes for heparin may include the much newer intravenous options include direct thrombin inhibitors such as Argatroban and bivalirudin. Warfarin needs to be monitored closely and is in many situations unpredictable. Later, patients need to be overlapped and transferred to Warfarin for the duration of treatment. The treatment for venous thromboembolism, including deep venous thrombosis and pulmonary embolism has long been anticoagulation in the form of intravenous unfractionated heparin. Still, anti Xa inhibitors are not appropriate for all indications. Also, there are antidotes which may or may not have clinically meaningful benefit. They are easy to take, have few interactions and are safer than Warfarin in most cases. Oral Xa inhibitors are becoming the most prescribed anticoagulants for atrial fibrillation and venous thromboembolism.
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