Uncle Tang has suffered from paroxysmal atrial fibrillation for many years and has been taking warfarin for anticoagulation. Recently, the follow-up doctor asked him to switch to rivaroxaban, saying that it was more convenient for monitoring. Is the old drug warfarin outdated?

Warfarin is a classic oral anticoagulant with effective efficacy and low price. The disadvantage is that there are many drug interactions, and patients need to draw blood regularly to monitor the International Normalized Ratio (INR). In recent years, novel oral anticoagulants (NOACs), including factor Xa inhibitor shaban and direct thrombin inhibitor dabigatran, have been shown to be effective in atrial fibrillation, pulmonary embolism, venous thromboembolism (VTE), hip and knee In terms of prevention and treatment of thrombosis after joint replacement, there is gradually a large amount of evidence-based medical evidence. National guidelines recommend: Elderly patients with atrial fibrillation, especially those who cannot or are unwilling to receive warfarin therapy, who have previously used warfarin for bleeding or whose INR is unstable, can be given priority to use NOACs.

Although NOAC is easy to use and has certain advantages in terms of efficacy and safety, it cannot be said that warfarin is outdated. Clinically, according to the different needs of patients, warfarin is still preferred over NOAC in terms of anticoagulant therapy such as valvular disease, artificial valve replacement, and antiphospholipid antibody syndrome.

Source: Medicine Gourd Baby