ximelagatran (Exanta)
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Introduction
zye-mel-a-gat-ran.
Not yet available in US.
May have been removed from market.[11]
Tradename: Exanta[5]
Indications
- prophylaxis for venous thromboembolism/deep vein thrombosis
- anticoagulation for non-valvular atrial fibrillation[2][6]
- prophylaxis for recurrent acute coronary syndromes?[4]
? ref 4 finds benefit
Dosage
- 20-40 mg PO BID (beginning morning after surgery)
- 20-60 mg PO BID (atrial fibrillation)
- 36 mg PO BID[10] NO need to monitor INR
Adverse effects
- minor bleeding (6-12%) <may be less than warfarin>
- transient elevation in serum ALT (4-12%)
- severe hepatic impairment (0.5%)[7]
- death (0.05%)[7]
- increased risk* of myocardial infarction[8][9] * less than that for patients taking warfarin[10]
Mechanism of action
More general terms
Additional terms
References
- ↑ Journal Watch 22(24):180, 2002 Francis CW et al Ann Inter Med 137:648, 2002
- ↑ 2.0 2.1 Journal Watch 23(16):125, 2003 Peterson P et al, J Am Coll Cardio 41:1445, 2003 PMID: https://www.ncbi.nlm.nih.gov/pubmed/12742279
- ↑ Journal Watch 23(23):182, 2003 Francis CW et al, N Engl J Med 349:1703, 2003 PMID: https://www.ncbi.nlm.nih.gov/pubmed/14585938 Schulman S et al, N Engl J Med 349:1713, 2003 PMID: https://www.ncbi.nlm.nih.gov/pubmed/14585939
- ↑ 4.0 4.1 Journal Watch 23(23):182-83, 2003 Wallentin L et al, Lancet 362:789, 2003 PMID: https://www.ncbi.nlm.nih.gov/pubmed/13678873 Giugliano RP & Brunwald E Lancet 362:757, 2003
- ↑ 5.0 5.1 Prescriber's Letter 10(12):72 2003 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=191216&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 6.0 6.1 Journal Watch 22(1):1, 2004 Sportif II Investigators, Lancet 362:1691, 2003 PMID: https://www.ncbi.nlm.nih.gov/pubmed/14643116
- ↑ 7.0 7.1 7.2 Setter SM. In: Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 29-Oct 2, 2004
- ↑ 8.0 8.1 Prescriber's Letter 11(11): 2004 Ximelagatran (Exanta) and Liver Toxicity Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=201106&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 9.0 9.1 Weitz JI. New anticoagulants for treatment of venous thromboembolism. Circulation. 2004 Aug 31;110(9 Suppl 1):I19-26. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15339877
- ↑ 10.0 10.1 10.2 Journal Watch 25(6):52, 2005
Fiessinger JN, Huisman MV, Davidson BL, Bounameaux H, Francis CW, Eriksson H, Lundstrom T, Berkowitz SD, Nystrom P, Thorsen M, Ginsberg JS; THRIVE Treatment Study Investigators. Ximelagatran vs low-molecular-weight heparin and warfarin for the treatment of deep vein thrombosis: a randomized trial. JAMA. 2005 Feb 9;293(6):681-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15701909
Albers GW, Diener HC, Frison L, Grind M, Nevinson M, Partridge S, Halperin JL, Horrow J, Olsson SB, Petersen P, Vahanian A; SPORTIF Executive Steering Committee for the SPORTIF V Investigators. Ximelagatran vs warfarin for stroke prevention in patients with nonvalvular atrial fibrillation: a randomized trial. JAMA. 2005 Feb 9;293(6):690-8. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15701910
Gurewich V. Ximelagatran--promises and concerns. JAMA. 2005 Feb 9;293(6):736-9. No abstract available. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15701916 - ↑ 11.0 11.1 Physician's First Watch, November 15, 2012 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society