Drawbacks of Established Anticoagulants
Although LMWHs are safe and effective as anticoagulants after THA and TKA, they require subcutaneous (sc.) administration. Fondaparinux, a synthetic pentasaccharide that inhibits thrombin generation by binding to anti-thrombin and selectively inhibiting factor Xa, also needs sc. administration.[10,11] Warfarin has the advantage of oral administration, but has a narrow therapeutic window with unpredictable pharmacokinetics and pharmacodynamics, which are affected by genetic factors, drug–drug interactions and foods containing vitamin K. Regular coagulation monitoring and dose adjustment of warfarin is required to ensure optimal anticoagulation (to maintain the international normalized ratio at 2–3).
Expert Rev Pharmacoeconomics Outcomes Res. 2011;11(3):299-306. © 2011 Expert Reviews Ltd.
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