使用利伐沙班需要注意什么事项

(Rivaroxaban) is a new type of anticoagulant. It is an inhibitor of factor xa, with a bioavailability as high as 80% to 100%. During medication, it can activate factor Compared with warfarin, it does not require dosage adjustment during medication and is not restricted by diet, age, etc.

However, it should be noted that different patients have different precautions, and there are certain differences in the dosage of medication.

1. People with kidney damage

The results of a study on the effects of rivaroxaban on renal function involving 32 subjects showed that volunteers with mild, moderate and severe renal impairment had 44%, 52% and 64% higher renal damage rates respectively than healthy volunteers. In patients with mild, moderate and severe renal impairment, urinary excretion of unchanged drug dropped to 20%, 13% and 10% respectively, compared with 29% in healthy controls. The clearance rate of rivaroxaban decreases with the increase in the degree of renal damage. The overall inhibition rate of xa factor activity in patients with mild, moderate and severe renal impairment is 1.5, 1.9 and 2.0 times that of the healthy control group, respectively; PT prolongation increases in a similar manner, being 1.3, 2.2 and 2.4 times respectively.

When using rivaroxaban clinically, the dose needs to be adjusted according to the patient's renal function to avoid adverse reactions.

2. People with liver damage

A single oral dose of rivaroxaban 10 was administered to 32 volunteers. mg, the changes in the pharmacokinetic and pharmacodynamic parameters of rivaroxaban in patients with mild or moderate liver damage were observed. The results showed that the pharmacokinetic parameters of rivaroxaban in patients with mild liver damage only changed slightly, and the AUC increased by an average of 15%, with no significant difference. The pharmacodynamic parameters of rivaroxaban in patients with moderate liver damage were significantly enhanced, the xa activity inhibition rate increased by 2.6 times, and the PT was prolonged by 2.1 times. The terminal half-life of patients with mild or moderate liver damage was approximately 2 hours longer than that of healthy volunteers.

(i.e., Xarelto) is contraindicated in patients with liver disease who are at risk for coagulation abnormalities and clinically relevant bleeding.

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