A review of the clinical uses of ximelagatran in thrombosis syndromes.

Ximelagatran, an oral direct thrombin inhibitor, has been investigated for the prevention and treatment of venous thromboembolism as well as for anticoagulation in atrial fibrillation. Unique properties of ximelagatran are that it is a prodrug, it does not require routine laboratory monitoring and it has minimal drug interactions. The dose of ximelagatran needs to be modified in patients with renal failure; however, dosing guidelines in this specific patient population have not been established. Preliminary and emerging data suggest that ximelagatran is superior or at least as effective as low molecular weight heparins and warfarin in the setting of venous thromboembolism prevention and treatment. Ximelagatran has comparable bleeding rates to low molecular weight heparins and warfarin; however, it is associated with transient elevations in hepatic transaminases.