The non-vitamin K oral anticoagulants reference a heritage blood thinner – warfarin, which is marketed as Coumadin – which has been on the market for over half a century. Requiring strict monitoring of diet and blood levels, warfarin is nonetheless proven effective as an anticoagulant with the added benefit of an antidote in the event of an unexpected bleeding event. To that end, an infusion of vitamin K succeeds in reversing the anticoagulant properties of warfarin, helping to stem an event that might otherwise place a patient in potential jeopardy.
Newer blood thinners such as Eliquis (apixaban) do not respond to vitamin K in the same fashion as warfarin. Plaintiffs considering Eliquis injury lawsuits allege the manufacturer was irresponsible in putting apixaban on the market without an antidote in place.
The study, published online in the Journal of the American Medical Association (JAMA) October 3, suggests a greater risk of bleeding events when NOACs are taken with drugs such as Rifadin, Diflucan and Dilantin.
Researchers in Taiwan studied data from more than 91,000 patients using the new crop of blood thinners, including Eliquis anticoagulant. The study authors found that the risk for a major bleeding event increased when patients on a NOAC anticoagulant for blood thinning were also prescribed amiodarone, or Rifadin (rifampin), Diflucan (fluconazole), and Dilantin (phenytoin).
“Among patients taking NOACs for nonvalvular atrial fibrillation, concurrent use of amiodarone, fluconazole, rifampin, and phenytoin compared with the use of NOACs alone, was associated with increased risk of major bleeding,” the researchers concluded. “Physicians prescribing NOAC medications should consider the potential risks associated with concomitant use of other drugs.”
Meanwhile there has been significant movement of late with regard to Eliquis lawsuits housed in multidistrict litigation.Law360 (10/13/17) reports that no fewer than 24 lawsuits against Pfizer Inc. and Bristol-Meyers Squibb Co. have been recently dismissed with prejudice resulting from a decision back in May by US District Judge Denise Cote with regard to an Eliquis lawsuit filed by plaintiffs Charlie and Clara Utts.
The plaintiffs in the Utts lawsuit argued that Eliquis labels lacked warnings with regard to the risk for internal bleeding. The Utts also argued that dosages should be tailored to the patient, with patients monitored after taking Eliquis in order to minimize risk.
However, Judge Cote ruled in May that pharmaceutical manufacturers can only alter labels given the availability of new information. That wasn’t relevant to the Utts action, which was filed in state court. The Judge Cote noted that claims stemming from more strict state laws would have been preempted by federal law, under which the US Food and Drug Administration (FDA) operates.
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According to Law360 the 24 lawsuits were originally filed in state court and quickly removed to federal court before the defendants had been properly served. Plaintiffs argued those circumstances created grounds for returning the litigation to state court. However the judge disagreed.
Law360 reported that 24 lawsuits were dismissed from the Eliquis MDL in June, with 20 additional lawsuits axed in July for reasons of substance.
The Eliquis MDL is in In re: Eliquis (Apixaban) Products Liability Litigation, Case No. 1:17-md-02754, in the US District Court for the Southern District of New York.