Consensus Recommendations for Preventing and Managing Bleeding Complications Associated with Novel Oral Anticoagulants in Singapore

摘要: Introduction: Novel oral anticoagulants (NOACs) have at least equivalent effi cacy compared to standard with similar bleeding risk. Optimal management strategies for complications associated NOACs are currently unestablished. Materials and Methods: A working group comprising haematologists vascular medicine specialists representing the major institutions in Singapore was convened produce this consensus recommendation. Medline EMBASE search conducted articles related 3 available (dabigatran, rivaroxaban, apixaban), its management. Additional information obtained from product monographs bibliographic of identifi ed. Results: The still has substantial interactions a number drugs which concomitant administration should best be avoided. As they renally excreted, albeit different degrees, not prescribed patients creatinine clearance <30 mLs/min. Meticulous consideration risk versus benefi ts exercised before starting patient on NOAC. In presenting bleeding, stratifi cation severity as well source performed. life-threatening bleeds, recombinant activated factor VIIa prothrombin complex may considered although their effectiveness is unsupported by fi rm clinical evidence. varying effect time partial thromboplastin interpreted caution. Routine monitoring drug level usually required. Conclusion: an important advancement antithrombotic careful selection will permit optimisation potential limit events. Ann Acad Med 2013;42:593-602