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Newer Anticoagulants

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Dear Members,Ximelagatran was the first oral direct thrombin inhibitor approved; however, it was subsequently withdrawn from the market because concerns of hepatic toxicity. Recently a new oral direct thrombin inhibitor, dabigatran, was approved for use in Europe for prevention of venous thromboembolism in patients who have undergone hip or knee replacement surgery. This drug has been shown to have equivalent efficacy and safety to LMWH. No routine monitoring is required. Thus, this drug has significant advantages over warfarin, which has a narrow therapeutic window, is affected by diet and many drugs, and requires monitoring for dosage adjustment. It appears that the direct thrombin inhibitors are poised to challenge warfarin's dominance in the prevention and therapy of thrombotic disease. Regards,Dr. Vijaya Chaudhari.JR-3,Dept. of Pharmacology,Government Medical College, Nagpur.

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