1. Non-vitamin K antagonist oral anticoagulant (NOACs) is a new direct oral anticoagulants(DOACs) that use to prevent thrombus pulmonary embolism, thromboembolism of deep vein and the ischemic stroke.
2. Do not forget to take the medicine, you should take the medication once you recall it. If you forgot to take the medicines (Dabigatran, Apixaban), you can take the medication dose once you missed in six hours.

1. Non-vitamin K antagonist oral anticoagulant (NOACs) is a new direct oral anticoagulants(DOACs) that use to prevent thrombus pulmonary embolism, thromboembolism of deep vein and the ischemic stroke cause by non-valvular atrial fibrillation.

Non-vitamin K antagonist oral anticoagulant (NOACs)

1. If you forget to take the medicine, you should take the medication once you recall it. If you forgot to take the medicines (Dabigatran, Apixaban), you can take the medication dose once you missed in six hours. Beside the medicine (Rivaroxaban, Edoxaban) can take in twelve hours. You should never take double of the prescription dose in the same day in order to make up for the missed dose .Do not adjust or stop taking medicine by yourself.

2. If any of the following symptoms occurs, please discontinue anticoagulant use and come back to the hospital immediately. Doctors will adjust the dose of medicine on the basis of your symptoms and examination result. Please obey doctors’ instructions to take medicine.
       A.Nosebleed.
       B.Blood in urine (Pink, red, or even bloody urine).
       C.Tarry stool.
       D.Vomiting with bloody vomitus.
       E.Coughing up of blood.
       F.Heavy menstrual bleeding.
       G.Serious bruises on your skin. 
   
       H.Allergy
       I.General reaction: skin itchy, rash, hive； Local reaction: swelling (include face, lip, tongue, throat).
   
       J.Others: difficulty breathing, chest pain, leg edema, hepatic disease, ischemic or hemorrhagic stroke
   

3. Avoid those activities might cause trauma, injury, wound, and hemorrhage. For example, contusion, heavy massage, or cutting too hastily. You should choose soft toothbrush in avoidance of gingiva injury. Men should use electric shavers instead of razors for shaving.
   
4. If you are injured and start to bleed, please direct pressure on your wound for 10–15 minutes to stop bleeding.
5. Before invasive treatment such as tooth extractions or surgeries, please inform your doctor in purpose to reduce the risk of bleeding (pause medicine and ask when to take it again).

6. For patients with renal dysfunction, doctors will adjust the dosage based on your kidney function data.
7. If you have the symptoms of cerebrovascular accident, such as difficulty walking, lose balance and coordination, difficultly speaking, paralysis in the face or serious bleeding, you need to back to the hospital immediately and accept the medical treatment.

        

This brochure listed simple and common questions and answers about anti-coagulants. If you have any questions about the anticoagulant you take, include the dosage, appearance, and necessary information you can consult your nurse, pharmacists or doctors. They could provide you more detailed instructions.

IV. Reference

1. 林雅如、黃英庭、崔百青、蔡力凱、鍾芷萍、郭書帆 （2019）‧2019 台灣腦中風學會非維他命 K拮抗劑口服抗凝血劑用於心房纖維顫動患者中風預防治療 指引‧台灣中風醫學雜誌，1(3)，143-184。https：//doi.org/：10.6318/FJS.201912_1(3).0001
2. 臺中榮民總醫院（2020）‧臺中榮總藥品手冊查詢系  統‧取自https://www.vghtc.gov.tw: 8080/  Pharmacy Handbook/handbook.html#/da0ta/LIX02。
3. Steffel, J., Collins, R., Antz, M., Cornu, P., Desteghe, L., Haeusler, K. G., Oldgren, J., Reinecke, H., Roldan-Schilling, V., Rowell, N., Sinnaeve, P., Vanassche, T., Potpara, T., Camm, A. J., Heidbüchel, H., & External reviewers (2021). European heart rhythm association practical guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. Europace. 23(10), 1612–1676. https://doi.org/10.1093/europace/euab065.