NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

NOAC Prescribing in Patients with Non-Valvular Atrial Fibrillation: Frequently Asked Questions

As previously reported the NHSGGC guideline for Atrial Fibrillation (AF) treatment now includes the option to use a Novel Oral Anticoagulant (NOAC) for anticoagulation.

The NOACs all have slightly different properties and the best choice of agent and dose may be dependent on individual patient characteristics.  A frequently asked questions document has been developed to aid GGC prescribers in the decision making process.

The document incorporates questions relating to:

  • Indications/appropriateness of NOACs
  • Choice of NOAC & dose
  • NOAC initiation & switching from warfarin
  • Further information and advice (e.g. monitoring requirements)

A few examples of questions from the document are listed below.  Follow the link above to see the answers to these questions and many more.

  • All three NOACs are indicated for AF and the dosing regimens are all different.   How do I choose the most appropriate agent and dose for my patient? 
  • Is there a preferred choice of NOAC in a patient with AF and renal impairment and is a dose reduction necessary?
  • I am commencing a NOAC in an elderly patient with AF and a low body weight.  Which NOAC at what dose is best?
  • My patient is on a number of other medicines.  Do any of the three NOACs have a more favourable interaction profile?