1.

Oral anticoagulants
The main indication for the use of Oral Anticoagulants is to treat deep vein thrombosis. Oral
anticoagulants are also used for the treatment of pulmonary embolism, atrial fibrillation with
the risk of embolization, post knee or hip replacement, and patients with mechanical
prosthetic heart valves.

Some of the drug content that is included in the category of Oral Anticoagulants, namely
Apiksaban, Dabigatran ethexylate, Rivaroksaban, and Sodium warfarin. Each of these
ingredients has indications, contraindications, dosages, and certain side effects.

1. Apiksaban
Indications - Prevention of venous thromboembolism in adult patients after hip or knee
replacement surgery.
Contraindications - Active bleeding, coagulopathy-related liver disease, and other risk
factors for bleeding.
Dosage - 2.5 mg twice daily and given 12-24 hours after surgery for 10-14 days (post knee
replacement surgery) or 32-38 days (post hip replacement surgery).
Side Effects - Anemia, bleeding, bruising, and nausea.
Trade Name - Eliquis

2. Dabigatran etheksilat
Indications - Primary prophylaxis of venous thromboembolism in postoperative adult
patients with total hip and knee replacement, prophylactic stroke and systemic embolism
in patients with atrial fibrillation, and treatment of acute deep venous thrombosis (DVT).
Contraindications - Hypersensitivity, severe kidney function disorders, bleeding
manifestations, spontaneous or pharmacological hemostasis disorders, severe liver
damage, etc.
Dosage - 1 capsule (110 mg dose / tablet) in a day ie 1-4 hours after surgery then continued
on the next day 2 x 1 capsule (110 mg) once a day for 10 days. Different cases require
different doses.
Side Effects - Nosebleeds, allergic reactions, dyspepsia, gastrointestinal bleeding, anemia,
abdominal pain, diarrhea, nausea, liver dysfunction, bleeding in the skin, and hematuria.
Trade Name - Campto, Pradaxa

3. Rivaroksaban
Indications - Reduces the risk of stroke and embolism in patients with nonvalvular atrial
fibrillation with a history of stroke.
Contraindications - Hypersensitivity, bleeding, liver disease associated with coagulopathy,
pregnancy, breastfeeding, and concomitant administration of azole antifungals.
Dosage - 15-30 mg once a day depending on the indication
Side Effects - Anemia, dizziness, headache, fainting, haemorrhagic eye (including
conjunctival hemorrhagic), tachycardia, hypotension, hematoma, hematoma, epistaxis,
gastronintestinal bleeding, and others

4. Sodium warfarin
Indications - Prophylactic embolization in patients with rheumatic heart and atrial
fibrillation, prophylaxis in patients post prosthetic heart valve installation, and patients with
transient cerebral ischemic attacks.
Contraindications - Pregnancy, peptic ulceration, severe hypertension, and bacterial
endocarditis.
Dosage - 10 mg daily for 2 to 4 days (initial dose) and 2-10 mg once a day (supporting dose)
Side Effects - Bleeding, allergic reactions, alopecia, diarrhea, nausea, vomiting, decreased
hematocrit, skin necrosis, purple toes, jaundice, liver dysfunction, etc.
Trade Name - Warfarin, Simarc

2. Parenteral anticoagulants

There are four types of parenteral anticoagulants, namely Heparin, low molecular weight
Heparin, Heparinoid, and Fondaparinuks.
1. Heparin
Indications - Treatment of deep vein thrombosis and pulmonary embolism, unstable
angina, prophylaxis in general surgery, and myocardial infarction.
Contraindications - Hemophilia, thrombocytopenia, peptic ulcers, recent cerebral
hemorrhage, severe hypertension, severe liver disease, kidney failure, and hypersensitivity
Dosage - Depends on medical indication
Side Effects - Bleeding, skin necrosis, thrombocytopenia, hypercalcemia, hypersensitivity
reactions, and osteoporosis.

2. Heparin low molecular weight

1. Dalteparin sodium
Indications - Prophylaxis in pre and post surgery
Contraindications - Hypersensitivity, thrombocytopenia, acute gastroduodenal ulcers,
cerebral hemorage, subacute endocarditis, sores and surgery on the CNS, eyes and ears.
Dosage - Depends on medical indication
Side Effects - Bleeding, skin necrosis, thrombocytopenia, hypercalcemia, hypersensitivity
reactions, and osteoporosis.

2. Enoxaparin
Indications - Treatment of venous thrombosis associated with orthopedic surgery or
general surgery, respiratory failure, severe infections, and rheumatic diseases.
Contraindications - Hemophilia, thrombocytopenia, peptic ulcers, recent cerebral
hemorrhage, moderate to severe arterial hypertension, and hypersensitivity.
Dosage - 20-40 mg per day depending on medical indications
Side Effects - Bleeding, skin necrosis, thrombocytopenia, hypercalcemia, hypersensitivity
reactions, and osteoporosis.
Trade Name - Lovenox

3. Nadroparin calcium
Indications - Prophylactic prevention of venous thromboembolism in surgery of patients
with moderate or high risk
Contraindications - Hypersensitivity, history of severe thrombopenia, organ lesions leading
to bleeding.
Dosage - Depends on medical indication
Side Effects - Bleeding, thrombocytopenia, hyperkalemia, hypersensitivity reactions
Trade Name - Fraxiparine, Fraxiparine Forte

4. Parnaparin
Indications - Prophylaxis of deep venous thrombosis and treatment of venous disorders due
to thrombotic conditions.
Contraindications - Pregnancy, breastfeeding, history of thrombocytopenia, bleeding,
severe nephropathy, pancreatopathy, severe arterial hypertension, hypersensitivity
Dosage - Depending on the patient's condition
Side Effects - Bleeding, allergic reactions, thrombocytopenia, and necrosis in the area of
the injection site.
Trade Name - Fluxum

3. Heparinoids
The content that is classified as Heparinoid is Danaparoid. Danaparoid is used in patients
undergoing general surgery or orthopedic surgery with the aim of prophylaxis in deep vein
thrombosis.

4. Fondaparinuks
Fondaparinuks is a synthetic pentasaccharide that inhibits activated factor X. The
ingredients that are included in Fondaparinuks are Sodium fondaparinuks. Sodium
fondaparinuks are used for prophylaxis of patients with venous thromboembolism.