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Compared to the risk of bleeding with warfarin use, direct factor Xa inhibitors have a higher risk of GI bleeding, but lower risk of bleeding in the brain. [2] Other side effects may include stomach upset, dizziness, anemia or increased blood levels of liver enzymes. [2]
Four drugs from the class of direct Xa inhibitors are marketed worldwide. Rivaroxaban (Xarelto) was the first approved FXa inhibitor to become commercially available in Europe and Canada in 2008. [1] The second one was apixaban (Eliquis), approved in Europe in 2011 [2] and in the United States in 2012. [3]
Apixaban was approved for medical use in the European Union in May 2011, and in the United States in December 2012. [7] [8] [14] It is on the World Health Organization's List of Essential Medicines. [15] In 2022, it was the 27th most commonly prescribed medication in the United States, with more than 19 million prescriptions.
Andexanet alfa, sold under the brand name Andexxa among others, is an antidote for the medications rivaroxaban and apixaban, when reversal of anticoagulation is needed due to uncontrolled bleeding. [8] It has not been found to be useful for other factor Xa inhibitors. [9] It is given by injection into a vein. [9]
Antihypertensive agents comprise multiple classes of compounds that are intended to manage hypertension (high blood pressure). Antihypertensive therapy aims to maintain a blood pressure goal of <140/90 mmHg in all patients, as well as to prevent the progression or recurrence of cardiovascular diseases (CVD) in hypertensive patients with established CVD. [2]
Medication that have label indications mean that they were approved by the FDA. This means that they are clinically significant for the indication and manufacturers are allowed to market their drug for the indication. [2] A drug can have more than one FDA labeled indication, which means that it can be used for multiple medical conditions. [5]
Glycoprotein IIb/IIIa inhibitors are frequently used during percutaneous coronary intervention (angioplasty with or without intracoronary stent placement).. They work by preventing platelet aggregation and thrombus formation.
Commonly prescribed drugs are prescribed according to guidelines around the world. For instance, for ischemic heart disease, the American College of Cardiology/American Heart Association (ACC/AHA) guideline is used in the United States and the European Society of Cardiology (ESC) guideline is used in Europe.