Nonheparin alternative anticoagulants that may be used in HIT patients
Anticoagulant . | Mechanism of action . | Application . | Clearance . | Half-life time . | Monitoring . |
---|---|---|---|---|---|
Parenterale | |||||
Argatroban | Direct thrombin inhibition | Intravenously | Hepatic | 40-50 min | aPTT |
Bivalirudin | Direct thrombin inhibition | Intravenously | Renal | 25 min | aPTT |
Danaparoid | Indirect inhibition of FXa | Intravenously, subcutaneously | Renal | 24 h | Danapariod–anti-Xa |
Fondaparinux | Indirect inhibition of FXa | Subcutaneously | Renal | 17-24 h | Fondaparinux–anti-Xa |
Oral | |||||
Dabigatran | Direct thrombin inhibition | Per oral | Renal (∼85%) | 12-14 h | — |
Rivaroxaban | Direct inhibition of FXa | Per oral | Renal (∼33%) | 5-9 h | — |
Apixaban | Direct inhibition of FXa | Per oral | Renal (∼25%) | 8-15 h | — |
Endoxaban | Direct inhibition of FXa | Per oral | Renal (∼50%) | 10-14 h | — |
Anticoagulant . | Mechanism of action . | Application . | Clearance . | Half-life time . | Monitoring . |
---|---|---|---|---|---|
Parenterale | |||||
Argatroban | Direct thrombin inhibition | Intravenously | Hepatic | 40-50 min | aPTT |
Bivalirudin | Direct thrombin inhibition | Intravenously | Renal | 25 min | aPTT |
Danaparoid | Indirect inhibition of FXa | Intravenously, subcutaneously | Renal | 24 h | Danapariod–anti-Xa |
Fondaparinux | Indirect inhibition of FXa | Subcutaneously | Renal | 17-24 h | Fondaparinux–anti-Xa |
Oral | |||||
Dabigatran | Direct thrombin inhibition | Per oral | Renal (∼85%) | 12-14 h | — |
Rivaroxaban | Direct inhibition of FXa | Per oral | Renal (∼33%) | 5-9 h | — |
Apixaban | Direct inhibition of FXa | Per oral | Renal (∼25%) | 8-15 h | — |
Endoxaban | Direct inhibition of FXa | Per oral | Renal (∼50%) | 10-14 h | — |
aPTT, activated partial thromboplastin time; FXa, activated coagulation factor X.