Direct oral anticoagulants (DOACs) such as apixaban and rivaroxaban are popular alternatives
to warfarin, but they are not suitable for every patient. The Clinical Excellence Commission’s
2025 guidelines specify that DOACs are contraindicated for individuals with mechanical heart
valves or rheumatic mitral stenosis, moderate‑to‑severe renal impairment, significant hepatic
disease, triple‑positive antiphospholipid syndrome, active bleeding, pregnancy or
breastfeeding, or those taking strong CYP3A4/P‑gp inhibitors. Different drugs also have
creatinine‑clearance cut‑offs (e.g., apixaban < 25 mL/min; rivaroxaban < 15 mL/min).
Patients should inform their doctors about all medications and medical conditions before starting
a DOAC. If a physician prescribes an anticoagulant despite clear contraindications, resulting
injuries could give rise to a malpractice claim.
The U.K. study gives patients reason to question whether or not their physician in the United States is paying proper attention to contraindications when prescribing anticoagulants. Improper prescription practice has major implications for the safety of patients in the U.S. and here in our state of Louisiana.
Consider that:
If you’ve been prescribed Xarelto or another anticoagulant drug, and you believe your doctor has failed to provide adequate safety warnings or has ignored safety warnings, contact us. Fill out the form on this page and someone from the law offices of Tony Tramontana will be in touch to discuss personal injury lawsuit options if you’ve been hurt by physician negligence.
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