Remember to weigh up risks and benefits of new PBS-listed anticoagulants (consumers)

1 September 2013

NPS MedicineWise is reiterating safety messages around the newer anticoagulant medicines dabigatran (brand name Pradaxa) and apixaban (Eliquis) with their PBS listing for preventing stroke on 1 September 2013. The safety messages also apply for rivaroxaban (Xarelto) which was PBS-listed last month.

These medicines will be subsidised by the Pharmaceutical Benefits Scheme (PBS) for preventing stroke in suitable people with atrial fibrillation (a medical condition where the heart beat is irregular), and may provide an alternative for some people.

However NPS MedicineWise clinical adviser Dr Andrew Boyden emphasises that there are risks associated with these medications and it is important to understand these.

“If you’re already taking an oral anticoagulant to prevent stroke, it’s crucial that you don’t stop taking your current anticoagulant suddenly without medical advice, as this may put you at risk of blood clots that could cause a stroke,” advises Dr Boyden.

“Talk to your doctor if you want to know more about the newer oral anticoagulants because — like all medicines — there are risks as well as benefits involved in taking them, and this is particularly important in the case of anticoagulants.

“Together with your doctor you can decide if one of the newer anticoagulants is an option for you based on your individual situation, medical conditions and lifestyle.”

The main side effect of all anticoagulants including dabigatran, apixaban and rivaroxaban is bleeding, however unlike warfarin, if you start bleeding while taking one of these newer anticoagulants, there is currently no way to reverse it quickly.

Dr Boyden emphasises that anyone taking an anticoagulant should be aware of the signs of bleeding.

“Ask your health professional what signs and symptoms you need to look out for, when you should contact your doctor about them and when you need to go to a hospital emergency department. Some signs of bleeding may not be obvious, so it is important to know what these are,” he says.

“It is also a good idea to talk to your health professional about ways to reduce your risk of injury and chances of bleeding.”

Unlike warfarin, people taking the newer anticoagulants don’t need to have regular INR blood tests. However there is currently no equivalent test to monitor how well these medicines are working.

“Even though you won’t need to have the INR blood tests, if you switch from warfarin to one of the newer anticoagulants, it’s still very important to have regular checks so your doctor can monitor your health.”

To help people find more information about the newer anticoagulant medicines available on the PBS and to make informed choices in conjunction with advice from their health professional, NPS MedicineWise has published information on its website.

For more information on prescription, over-the-counter and complementary medicines (herbal, ‘natural’, vitamins and minerals) from a health professional, call NPS Medicines Line on 1300 MEDICINE (1300 633 424) . Hours of operation are Monday–Friday 9am–5pm AEST (excluding public holidays).


Independent, evidence-based and not-for-profit, NPS MedicineWise enables better decisions about medicines and medical tests. We are funded by the Australian Government Department of Health and Ageing.

If you are a journalist seeking comment on a story or more information on any of our programs or campaigns please contact one of our media advisers: Stephanie Childs on 02 8217 8667 or Erin Jardine on 02 8217 8733 (during office hours) or call the NPS MedicineWise media phone on 0419 618 365 (for urgent media requests outside of office hours). If your enquiry is not urgent you can also send us an email.