Anticoagulation Myth Busters

MYTH

“My patient is unable to swallow and therefore cannot have a NOAC”

REALITY

“For patients who are unable to swallow whole tablets, apixaban and rivaroxaban may be crushed and mixed with water, apple juice or apple puree prior to administration.”1,2

For drug administration via a nasogastric/enteral feeding tube, data have shown that administration in the crushed form does not alter the bioavailability of apixaban, edoxaban or rivaroxaban.3

Dabigatran capsules must not be opened since doing so will result in a substantial increase in drug bioavailability; as such capsules must be administered whole.3

.REFERENCES
  1. SmPC Apixaban. medicines.org.uk: medicines.org.uk; 2019.
  2. SmPC Rivaroxaban. medicines.org.uk: medicines.org.uk; 2019
  3. Steffel J, Verhamme P, Potpara TS, Albaladejo P, Antz M, Desteghe L, et al. The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: executive summary. Europace. 2018.
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