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DAR N0 8: Rivaroxaban (Xarelto®) for atrial fibrillation
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Is it good to lose control?
- Rivaroxaban is an oral anticoagulant that does not require monitoring of prothrombin time (INR) and lacks an antidote.
- It has shown comparable efficacy and safety profiles with warfarin in one trial but anticoagulation with the latter was deficient.
- When anticoagulation control was adequate, no differences in the incidence of stroke or systemic embolism were found, and there were fewer cases of bleeding under warfarin.
- There are no direct comparisons with other new oral anticoagulants.
- Until more evidence on safety is available and given its high cost, it should only be used when adequate anticoagulation is impossible with vitamin K antagonists.
