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A new oral anticoagulant is now available. Edoxaban (Lixiana) is a once-daily, direct factor Xa inhibitor indicated to prevent stroke and systemic embolism in adults with non-valvular atrial fibrillation and at least one risk factor, including congestive heart failure, hypertension, diabetes, prior stroke or transient ischaemic attack.

Edoxaban is also approved to treat and prevent recurrent deep vein thrombosis and pulmonary embolism. Expenditure on anticoagulants and protamine rose by 47.8 per cent between 2013- 14, reaching £138.6m. The rise reflects greater use of three new oral anticoagulants, according to the HSCIC.