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1. Only rivaroxaban is currently approved and subsidised in Australia for treatment of DVT and PE.

2. Its efficacy is comparable to that of warfarin for prevention of recurrent VTE but it has a lower bleeding risk.

3. High-risk patients, such as those with antiphospholipid syndrome and recurrent thrombotic events, were excluded from clinical trials and warfarin should remain the standard of care for these patients until NOACs have been evaluated.

4. All NOACs are small molecules that cross the placenta and are contraindicated in pregnant and breastfeeding patients.

5. Dabigatran, rivaroxaban and apixaban were evaluated for extended (6–12 months) treatment of VTE & showed reduced risk of recurrence. However, only dabigatran was compared with warfarin.


1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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