2.8.2 Oral anticoagulants

1.1 Dabigatran etexilate is recommended as an option for the prevention of stroke and systemic embolism within its licensed indication, that is, in people with nonvalvular atrial fibrillation with one or more of the following risk factors:

• previous stroke, transient ischaemic attack or systemic embolism

• left ventricular ejection fraction below 40%

• symptomatic heart failure of New York Heart Association (NYHA) class 2 or above

• age 75 years or older

• age 65 years or older with one of the following: diabetes mellitus, coronary artery disease or hypertension.

1.2 The decision about whether to start treatment with dabigatran etexilate should be made after an informed discussion between the clinician and the person about the risks and benefits of dabigatran etexilate compared with warfarin. For people who are taking warfarin, the potential risks and benefits of switching to dabigatran etexilate should be considered in light of their level of international normalised ratio (INR) control.

https://www.nice.org.uk/guidance/TA249

1.1 Rivaroxaban is recommended as an option for the prevention of stroke and systemic embolism within its licensed indication, that is, in people with nonvalvular atrial fibrillation with one or more risk factors such as:

• congestive heart failure

• hypertension

• age 75 years or older

• diabetes mellitus,

• prior stroke or transient ischaemic attack.

1.2 The decision about whether to start treatment with rivaroxaban should be made after an informed discussion between the clinician and the person about the risks and benefits of rivaroxaban compared with warfarin. For people who are taking warfarin, the potential risks and benefits of switching to rivaroxaban should be considered in light of their level of international normalised ratio (INR) control.

https://www.nice.org.uk/guidance/TA256

1.1 Rivaroxaban is recommended as an option for treating pulmonary embolism and preventing recurrent deep vein thrombosis and
pulmonary embolism in adults.

https://www.nice.org.uk/guidance/TA287

1.1 Apixaban is recommended as an option for preventing stroke and systemic embolism within its marketing authorisation, that is, in people with nonvalvular atrial fibrillation with 1 or more risk factors such as:

• prior stroke or transient ischaemic attack

• age 75 years or older

• hypertension

• diabetes mellitus

• symptomatic heart failure.

1.2 The decision about whether to start treatment with apixaban should be made after an informed discussion between the clinician and the person about the risks and benefits of apixaban compared with warfarin, dabigatran etexilate and rivaroxaban. For people who are taking warfarin, the potential risks and benefits of switching to apixaban should be considered in light of their level of international normalised ratio (INR) control.

https://www.nice.org.uk/guidance/TA275

1.1 Dabigatran etexilate, within its marketing authorisation, is recommended as an option for the primary prevention of venous thromboemolic events in adults who have undergone elective total hip replacement surgery or elective total knee replacement surgery.

https://www.nice.org.uk/guidance/TA157

1.1 Apixaban is recommended as an option for the prevention of venous thromboembolism in adults after elective hip or knee replacement surgery.

https://www.nice.org.uk/guidance/TA245

1.1 Rivaroxaban, within its marketing authorisation, is recommended as an option for the prevention of venous thromboembolism in adults having elective total hip replacement surgery or elective total knee replacement surgery

https://www.nice.org.uk/guidance/TA170

1.1 Rivaroxaban is recommended as an option for treating deep vein thrombosis and preventing recurrent deep vein thrombosis and pulmonary embolism after a diagnosis of acute deep vein thrombosis in adults.

https://www.nice.org.uk/guidance/TA261

1.1 Dabigatran etexilate is recommended, within its marketing authorisation, as an option for treating and for preventing recurrent deep vein thrombosis and pulmonary embolism in adults.

https://www.nice.org.uk/guidance/TA327

1.1 Rivaroxaban is recommended as an option within its marketing authorisation, in combination with aspirin plus clopidogrel or aspirin alone, for preventing atherothrombotic events in people who have had an acute coronary syndrome with elevated cardiac biomarkers.

1.2 Clinicians should carefully assess the person's risk of bleeding before treatment with rivaroxaban is started. The decision to start treatment should be made after an informed discussion between the clinician and the patient about the benefits and risks of rivaroxaban in combination with aspirin plus clopidogrel or with aspirin alone, compared with aspirin plus clopidogrel or aspirin alone.

1.3 A decision on continuation of treatment should be taken no later than 12 months after starting treatment. Clinicians should regularly reassess the relative benefits and risks of continuing treatment with rivaroxaban and discuss them with the patient.

http://www.nice.org.uk/guidance/ta335 

1.1 Apixaban is recommended, within its marketing authorisation, as an option for treating and for preventing recurrent deep vein thrombosis and pulmonary embolism in adults.

http://www.nice.org.uk/guidance/ta341

1.1 Edoxaban is recommended, within its marketing authorisation, as an option for preventing stroke and systemic embolism in adults with non‑valvular atrial fibrillation with one or more risk factors, including:

• congestive heart failure

• hypertension

• diabetes

• prior stroke or transient ischaemic attack

• age 75 years or older.

1.2 The decision about whether to start treatment with edoxaban should be made after an informed discussion between the clinician and the person about the risks and benefits of edoxaban compared with warfarin, apixaban, dabigatran etexilate and rivaroxaban. For people considering switching from warfarin, edoxaban's potential benefits should be considered against its potential risks, taking into account the person's level of international normalised ratio (INR) control.

http://www.nice.org.uk/guidance/ta355 

1.1 Edoxaban is recommended, within its marketing authorisation, as an option for treating and for preventing recurrent deep vein thrombosis and pulmonary embolism in adults.

http://www.nice.org.uk/guidance/ta354