Oral Anti-Coagulants

For decades, there have been very few options for patients on anticoagulants (commonly called “blood thinners”). Only one of these options can be taken orally (by mouth): warfarin. Warfarin interacts with many other medications and food, and requires frequent blood tests for monitoring. Often, the dose must be adjusted to stay in the safe range.

For this reason, many children are not treated with warfarin and instead receive enoxaparin, a medication that must be injected into the skin twice a day. Recently, several new anticoagulants have been approved by the Federal Drug Administration (FDA) to treat adults.

Advantages of the new anticoagulants

These anticoagulants can be taken by mouth and do not require monitoring. They are not affected by most medications or changes in diet.

Are there any disadvantages?

The main disadvantage is that there is currently no way to immediately reverse the effect of the anticoagulant if a patient is bleeding or needs a procedure. There are ways to reverse warfarin.

Can the new anticoagulants be used in children?

Currently, the FDA has not approved any of these medications for use in children.

Clinical trials of new anticoagulants in children

In order to use these new blood thinners in children, they must be studied to determine 1) if they are safe, 2) if they protect children from blood clots, and 3) the correct dose for children. The best way to answer these questions is to perform a research study, or clinical trial.

The Hemostasis and Thrombosis Center at CHOP will be participating in some of the clinical trials to evaluate these new blood thinners. If your child is eligible, you may be asked to participate. The research staff will explain each study in detail, and you can decide whether you want to participate.

If you have any further questions, please call Dr. Raffini at 267-426-5029.