A Clearinghouse for Information about Blood Clots (DVT/)PE) and Clotting Disorders (thrombophilia) provided as a public service by the University of North Carolina Blood Research Center

Category: Uncategorized

  • Hip and Knee Replacement Surgery – DVT Prophylaxis – AAOS Guideline

    Two main guidelines exist which many physicians go by to decide whether a particular patient should get DVT prophylaxis after hip or knee replacement surgery, what method (compression device, or pharmacologic agent) to use, and for how long to give prophylaxis.  (a) One is the ACCP guideline (American College of Chest Physicians), last published in June 2008…

  • Yasmin, Yaz and Other Drospirenone Contraceptives: Risk for VTE

    It has long been known that estrogen-containing birth control preparations (pill, patch, ring) increase the risk for DVT and PE (venous thromboembolism = VTE).  This risk is partially due to the estrogen.  However, part of the risk is also due to the type of progestin in these preparations.

  • Arixtra (Fondaparinux), Generic

    “Is the generic version of Arixtra as safe and effective as brand Arixtra?”  Answer: “Yes”. The FDA evaluated and approved generic fondaparinux made by Dr. Reddy’s Laboratories Ltd. on July 11, 2011

  • Nattokinase

    Your patient may inquire whether he/she can take Nattokinase instead of staying on warfarin to prevent future venous thromboembolism; or what you think about the effectiveness of Nattokianse in preventing a first or recurrent DVT or PE.

  • Rivaroxaban (Xarelto): Advisory Board to the FDA Recommends Approval for Atrial Fibrillation

    The external advisory board to the FDA recommended today (Sept 8th, 2011) to approve Rivaroxaban (Xarelto) for the stroke prevention in atrial fibrillation.  More details about the vote can be found here.  Today’s recommendation is contrary to the one given by an internal FDA review committee which had recommended 2 days ago to NOT approve the…

  • Rivaroxaban (Xarelto): FDA Advisory Board Recommends Against Approval for Atrial Fibrillation

    Surprise to many people today:  An FDA staff report released today (Sept 6th, 2011) states that FDA reviewers recommend against the approval of rivaroxaban (Xarelto) for the atrial fibrillation indication.  A detailed discussion with reasons for the recommendation can be found here.  The main reason: It has not been shown that rivaroxaban is as effective as…

  • Minor Cuts and Nosebleeds on Anticoagulants

    When a patient on warfarin bleeds more than usual it is, of course, important to make sure that the INR is not supra-therapeutic.  And, if the INR is too high, warfarin therapy needs to be adjusted and other treatment (vitamin K, etc) may have to be employed depending on the degree of INR elevation and…

  • Apixaban (Eliquis) News – Plus Update On The Big Four New Oral Anticoagulants

    There is a lot of appropriate interest and excitement today about one of the four new oral anticoagulants in development – Apixaban (Eliquis). Data from the large ARISTOTLE trial were published today in the NEJM, showing that in patients with atrial fibrillation Apixaban was more effective in preventing stroke and systemic thromboembolism, caused less major bleeding, and resulted…