Antithrombotic therapies, particularly unmonitored fixed-dose oral anticoagulants, are associated with significant bleeding complications.
Warfarin may remain safest for long-term oral anticoagulation; leaves open whether fixed-dose NOACs match its safety in real-world use.
Antithrombotic therapy is associated with significant medical complications, particularly bleeding of the anticoagulants used long term by the oral route, warfarin is the safest because the dosage is regularly adjusted according to the results of INR tests. There have recently come into common use a number of oral anti-coagulants that are given as a fixed dose with no monitoring. These include rivaroxaban, dabigatran, apixaban and edoxaban and a number of blockers of the coagulation cascade, such as Factor Xa and thrombin in inhibitors. Injected heparin and low-molecular heparins are mostly used for emergency or initial circumstances. The side effects of adminstration of such drugs are haematuria, melena, epistaxis, ecchymosis, hematemesis, haemoptysis, haemorrhagic stroke and heavy periods in women.
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Mark I. M. Noble (2018) studied this question.
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