DETAILS – Pharmacokinetics of rivaroxaban
Québec, April 1, 2014 – INESSS has provided details on the excretion of rivaroxaban in its guide entitled “Anticoagulant therapy for adult patients – atrial fibrillation”. This change concerns the percentage of the rivaroxaban dose excreted by the kidneys in its active form (unchanged) and in its inactive form. The following publications were consulted with regard to this change:
Scaglione F. New oral anticoagulants: comparative pharmacology with vitamin K antagonists. Clin Pharmacokinet. 2013 Feb;52(2):69-82.
Wang Y, Bajorek B. New Oral Anticoagulants in Practice: Pharmacological and Practical Considerations. Am J Cardiovasc Drugs. 2014 Jan 23. [Epub ahead of print].
Savelieva I, Camm AJ. Practical considerations for using novel oral anticoagulants in patients with atrial fibrillation. Clin Cardiol. 2014 Jan;37(1):32-47.
Bayer Inc. PrXarelto® rivaroxaban tablet 10 mg, 15 mg and 20 mg Anticoagulant: Product monograph. Toronto, ON: Bayer Inc.; 2013. Available at׃ http://www.bayer.ca/files/XARELTO-PM-ENG-28AUG2013-164839.pdf.
On October 1, 2012, rivaroxaban (Xarelto®) was added to the List of Medications reimbursed by the Régie de l’assurance maladie du Québec, for the prevention of stroke and systemic embolism in patients with atrial fibrillation. Clinicians now have several treatment options.
Consequently, INESSS, working with a committee of experts, has prepared a clinical tool that presents relevant characteristics of oral anticoagulants to help physicians determine the most appropriate anticoagulant treatment.
The purpose of this clinical tool is to provide quick access to practical information useful in decision making. The information comes from official monographs and published studies on the new oral anticoagulants. This tool is provided for information purposes only and should not replace the judgment of a professional.
Members of the committee of experts
- Dr. Mathieu Bernier, cardiologist, Institut universitaire de cardiologie et de pneumologie de Québec
- Dr. Annik Dupras, geriatrician internist, Hôpital Notre-Dame, Centre hospitalier de l’Université de Montréal
- Dr. Isabelle Greiss, cardiologist, Hotel-Dieu, Centre hospitalier de l’Université de Montréal
- Dr. Jeannine Kassis, hematologist, Hôpital Maisonneuve-Rosemont
- Mr. Martin Turgeon, pharmacist, Pavillon Hotel-Dieu, Centre hospitalier de l’Université de Sherbrooke
- Dr. Martin Albert, internist-intensivist, Hôpital du Sacré-Cœur de Montréal (external reader)
- Mr. Georges-Émile Bourgault, pharmacist, Pharmacie Yves Boissinot & Andrée Thiffault (external reader)
- Dr. Anne Bruneau, UMF Montréal, Clinique médicale de Montréal (external reader)
Declaration of interests
Dr. Jeannine Kassis, member of the committee of experts, has received research funding from Pfizer and Boehringer Ingelheim for studies on apixaban and dabigatran, respectively.