Always consider non-prescription drugs.
| When the GP prescribes the new oral anticoagulant, he reviews all of Stuart’s medication regimine. | ||
|---|---|---|
| Ramipril 5mg BD | Continue | As Stuart has a history of hypertension and myocardial infarction, Ramipril should be continued. |
| Bisoprolol 5mg BD | Continue | As Stuart has a history of myocardial infarction, Bisoprolol should be continued. The dose may have to be increased to control his heart rate now he has AF. |
| Simvastatin 40mg | Continue | As Stuart has a history of myocardial infarction, Simvastatin should be continued. |
| Aspirin 75mg OD | STOP | Treatment with Aspirin should be reviewed when staring an anticoagulant. In patients with stable coronary artery disease, Aspirin should be stopped. |
| St John’s Wort | Maybe! | If Stuart is to be started on Warfarin, he should be discouraged from self-medicating with St John’s Wort. This can increase the effect of anticoagulants like Warfarin. If a novel anticoagulant is used instead, there is no interaction. |
Pulse point
The choice of first line anti-coagulation will be determined local policy and protocols.
Do you know what your local policy is?
Page last reviewed: 30 Jul 2020
