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.
The Cardiac Advisory Group of the Northern England Strategic Clinical Networks are in the process of distributing and publicising a generic NOAC Alert Card they have developed to clearly inform patients and healthcare professionals of key safety information regarding the use of novel oral anticoagulants (NOACs).
Primary and secondary care pharmacists have been asked to issue the card to patients when they issue the prescription.
If your practice would like a supply of the NOAC Alert Card to issue yourselves please email firstname.lastname@example.org to request these.
The card includes advice to the patient about what symptoms and signs should concern them and who to contact if problems develop with clear lines of responsibility. Useful information for healthcare workers includes the indication and duration for the treatment and advice on how to manage common complications and concerns.
The card was developed in consultation with all stakeholders within our clinical networks as a standardised and easily recognisable tool for use across the region.
To read more, and see an example of the card, please use the link below: