NOACs contraindicated in patients with mechanical heart valves

Prescribers are reminded not to substitute newer oral anti-coagulant drugs (NOACs) for warfarin in patients with mechanical heart valves under any circumstance because of the risk of thromboembolic and bleeding events, regardless of the length of time since the replacement.  This warning relates to any of the drugs in this class (dabigatran, edoxiban, rivaroxiban and apixiban).

Please refer to the Summary of product Characteristics for each drug for full prescribing information.

http://webarchive.nationalarchives.gov.uk/20150122075153/http:/www.mhra.gov.uk/home/groups/dsu/documents/publication/con254819.pdf