Rivaroxaban and factor Xa inhibitors in clinical practice

Prevention and treatment of thrombosis represent some of the most common medical interventions in the clinical area that remains among the most common causes of mortality and morbidity. At present, heparins, pentasaccharides and warfarin are used to prevent thromboembolic events. Nevertheless, these drugs have a range of adverse effects and other disadvantages that force scientists to seek new treatment options that would fulfil the concept of an 'ideal antithrombotic drug'. Characteristics of such an agent include selectivity of its effect, absence of adverse effects, possibility to administer the drug without the need for laboratory control and low cost. Attention is, therefore, focused on thrombin modulation either with direct inhibitors or with inhibitors of the thrombin production system, i.e. activated factor Xa of the plasma coagulation cascade (F Xa). Management so far involved injectable formulations, the efforts described above aim for oral administration of treatment.