"Pradax" - analogs. "Warfarin", "Xarelto": reviews, prices

Among the antithrombotic agents used to eliminate thromboembolism in the veins after surgical interventions, the Pradax drug is most effective. Analogues of it have wider indications for use and in their composition have different active components. Anticoagulants are produced in solid dosage form with different dosages.

Description of the preparation "Pradaxa"

The manufacturer of antithrombotic and anticoagulant medication "Pradax" is the company "Behringer Ingelheim Pharma GmbH & Co. KG. KG ". The product is produced in hard capsules, inside which there are small yellow granules. The active substance is dabigatran etexilate in an inactive form, the amount of which determines the dosage of the drug. It can be 75 mg, 110 mg and 150 mg.

Why use the drug "Pradaxa"

The main purpose of capsules is associated with the prevention of venous thromboembolism after surgical interventions in the departments of the musculoskeletal system.

How the "Pradax" tool works

The mechanism of action of the Pradax drug is associated with the suppression of thrombin activity. Analogs have slightly different properties. Being a low molecular weight compound, dabigatran etexilate does not have a pharmacological effect.

Only after entering the human body, this substance after hydrolysis splits to free dabigatran, which is an active competitive reversible direct inhibitor of the thrombin enzyme. The role of thrombin is to bind fibrin, thrombin, to reduce platelet aggregation caused by thrombin activity.

Such means

There are analogues in the Pradax preparation. But in their composition they do not contain dabigatran etexilate, it is replaced by other anticoagulant substances. Thus, warfarin serves as an active component of the similar drug "Warfarin", rivaroxaban is contained in the medicine "Xarelto". Synonyms of the preparation "Pradaksa" under the name "Markumar" and "Phenylin" include fenprokumon and fenindion respectively.

Description of the drug Warfarin

We have already enumerated the analogs of the "Pradaksa" medication. Let us now consider in more detail one of them.

The drug "Warfarin" is released in the form of tablets with a dosage of the active component of 2.5 mg. The manufacturer of the drug is the Russian company "Canonfarma Production".

There are other dosages (1 mg, 2 mg, 3 mg and 5 mg) of foreign medicines based on warfarin. The shape, color and size of the tablets are different, on one side the dosage is in mg.

What is the drug used for?

Reception "Warfarin" is possible:

• With thrombosis of the venous system or predisposition;
• For prophylactic treatment of thrombosis and thromboembolism;
• In acute venous thrombosis and thromboembolism in the lung tissue;
• With postoperative thrombosis;
• With acute myocardial infarction;
• During surgical and thrombolytic therapy of thrombosis;
• With a transient attack of ischemic disease;
• For the long-term treatment of recurrent venous thrombosis;
• During the prosthetic valve in the heart.

How the remedy works

Special elements of the substance "Warfarin" reduce the coagulability of blood, inhibit the production of factors (X, IX, VII, II), dependent on vitamin K and causing blood clotting. Anticoagulant hepatic proteins S and C are synthesized to a lesser extent under the influence of the drug. All this reduces the formation of blood clots, leading to the formation of blood clots.

To eliminate venous thrombosis, doctors prescribe treatment with indirect anticoagulants. This does not allow the development of a repeat thrombosis, which can cause complications.

Calculation of the dose of warfarin with different indices of INR

The purpose of the drug "Warfarin" is possible after a detailed examination, during which all contraindications are revealed. Based on the results of the analysis, the necessary amount of the Warfarin medication is selected for further treatment. The dose per day should not exceed 5 mg of the main active substance. With insufficient therapeutic effect, correction of treatment is carried out. It is recommended to record the received doses, the level of MNO and the resulting effects for the analysis of therapy.

Under the INR (International Normalized Ratio) is meant a standard for determining the coagulation activity of blood elements. Coagulation factors affect the values of the indicator. It is important to control the INR when taking "Warfarin", whose rationing is inversely proportional to the coagulability of the blood. Thus, at high values of the normalized ratio, coagulability slows down and hypocoagulation increases.

For different states, it is necessary to keep certain INRs under control.

1. For a healthy organism, its rate is about 1.0 (or deviates slightly - from 0.85 to 1.25).
2. Chronic atrial fibrillation with the use of "Warfarin" tablets should be accompanied by a normalized ratio of 2.0 to 3.0 units.
3. The mechanical prosthesis of the valve is characterized by an INR of 2.0 to 3.0, a mechanical prosthesis of the mitral valve from 2.5 to 3.5.
4. When treating thromboembolism in the pulmonary artery and some heart defects, the level of the index is required from 2.0 to 3.0.
5. To prevent thrombosis in the deep veins after surgery and for the treatment of venous thrombosis, adhere to the values of 2.0-3.0.

The drug "Warfarin" should be administered with close monitoring of the INR indicator and strict observation by the doctor so that the dosage can be regulated. Stabilization of the normalized ratio and selection of the required amount of medication is carried out in about one week, and then this value is checked every 4 weeks.

In order to achieve the effect of using the drug "Warfarin", how to take, than wash down and whether it is possible to combine with food, you need to know. Tablets are drunk twice a day, not combining with eating. They are washed down with water and taken at one time. In addition, the delivery of analyzes to the INR should be at the same time and in a permanent laboratory. If a dose is missed, the next dose should be taken on time.

When the INR is less than 2.0, blood is considered dense, the drug is ineffective, so a higher dose of Warfarin should be used.

With an INR of more than 3.0, blood is considered liquid, bleeding may occur, so a lower dosage should be used.

The price of the Warfarin medication

In comparison with the German medicinal product of Pradax, its Russian counterpart Warfarin, the price for which is 80 rubles per package, is much cheaper and more affordable.

Description of the drug "Xarelto"

The "Pradax" medication can have analogues with the properties of anticoagulants with direct action. These include the drug "Xarelto". It is produced in the form of round tablets in a film shell by the German company Bayer.

The composition contains rivaroxaban in micronized form. Tablets "Xarelto" come in the following dosages: 2.5 mg, 10 mg, 15 mg and 20 mg.

Mechanism of action

Rivaroxaban is classified as highly selective direct Xa factor inhibitors, which have a high bioavailability after oral administration.

The coagulation cascade is formed by the activation of factor X, which, due to the internal and external coagulation pathway, is converted to factor Xa. This component is involved in the formation of a prothrombinase compound, from the action of which prothrombin is converted into thrombin. All these processes form a fibrin clot and activate platelets. There is an "explosion" in which up to 1 thousand of these blood cells are synthesized due to one X-factor molecule.

With the help of selective inhibitors, which reduce the activity of the activator, the "thrombin explosion" stops. The action of rivaroxaban is aimed at changing the results of specific or general laboratory analysis, by which the condition of the coagulation system is evaluated. The activity of the X factor changes depending on the dose of the inhibitor used by the Xarelto preparation (15 mg tablets or other dosages thereof).

What is being treated with this drug

The instructions describe the use of a medication to prevent mortality after cardiovascular disease associated with heart muscle infarction and acute coronary syndrome. The drug "Xarelto" positive reviews received for effective combined treatment with aspirin or with aspirin and thienopyridine.

How to take different doses of the drug

The drug is intended for internal use. Tablets of all dosages are taken with meals.

To eliminate acute coronary syndrome it is recommended to take one tablet of 2.5 mg twice a day. Together with the drug "Xarelto" (reviews indicate the effectiveness of using this combination), you can take acetylsalicylic acid in a daily dose of 75 to 100 mg, as well as a combination of aspirin and clopidogrel at 75 mg per day. Such therapy requires constant monitoring of the physician to maintain equilibrium, the displacement of which in one of the parties can cause ischemic problems or bleeding. Taking the drug is long and takes about one year, in some patients it reaches two years.

Tablets in a dosage of 10 mg of rivaroxaban are taken once a day. The first drink after 6-9 hours the field of surgical intervention with effective hemostasis. Duration of treatment with such a quantity of the drug is determined for each patient separately and depends on the risk of thromboembolism in the veins, complexity and type of operation.

When replacing the hip joint, the period of taking the Xarelto medication (10 mg tablets) lasts up to 5 weeks, and with the prosthetic knee, it takes 14 days.

If the patient has forgotten to drink one dose of rivaroxaban, it should be immediately consumed, and the next day continue treatment with 1 tablet.

Higher dosages of 15 mg and 20 mg are also taken not on an empty stomach.

In order to prevent stroke and thromboembolism of a systemic nature in the non-valvular heart atrial fibrillation, one tablet is used with a dosage of 20 mg once a day.

In renal failure, when the half-life of creatinine is less than 30 ml per minute, use a dose of 15 mg once a day.

The duration of treatment depends on the presence of a threat of stroke and thromboembolism of a systemic nature.

The maximum allowable daily dosage should not be more than 20 mg of rivaroxaban.

In thrombosis involving deep veins, the initial dose of 15 mg twice daily for the first three weeks is used to prevent the recurrence of this disease and for thromboembolism affecting the pulmonary artery. Later they switch to 20 mg rivaroxaban tablets once a day for longer treatment and prevent recurrence of thrombosis and thromboembolism of the pulmonary artery.

It is not always possible for patients to swallow a whole tablet, especially large ones, then it can be chopped and mixed with clean water or liquid food before use. Immediately after taking the drug, the patient should eat.

It is also possible to administer the ground tablet with a gastric probe, the position of which in the digestive system is in advance coordinated with the treating doctor. The rules for applying the ground tablets in this way consist in mixing the drug with a small amount of water and then introducing it. After that, a little more liquid is poured in order to remove the remnants of the drug from the probe. Following the medication it is necessary to carry out enteral intake of food.

The price of the drug "Xarelto"

This drug refers to imported drugs with high cost. For example, the drug "Xarelto" price of the smallest dose will be 56 tablets about 950 rubles. It is much more expensive than its Russian counterpart - the drug "Warfarin". The medicine "Xarelto" price increases depending on the increase in dosage. Thus, the cost of 14 tablets of 15 mg of rivaroxaban will be about 850 rubles, and for packing (28 pills) with the highest dosage (20 mg of the main active substance), you will have to pay from 1,450 rubles.