Anticoagulantia in vaste dosis

The recent registration of 2 new selective anticoagulants (rivaroxaban and dabigatran) is a milestone in pharmaceutical development. Fewer interactions and stable kinetics allow for fixed-dose administration of these drugs. These advantages appear to apply for short term prescription in highly selected groups of patients. However, in the case of long-term administration of such drugs in unselected groups of patients, the possibility to determine dose response effects by a laboratory test may be of paramount importance. Arguments for such testing include the fact that fixed dosing is against the principle of individual tailored therapy. Testing is also indispensible in the determination of compliance and in the case of complications including thrombosis and bleeding. It will be important to consider laboratory control of this novel class of anticoagulants if these are to be used safely and effectively for long-term anticoagulation treatment in general practice.