Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Dec 10;8(4):57-72.
eCollection 2018.

Use of direct oral anticoagulants in daily practice

Feras Almarshad  1 , Ali Alaklabi  2 , Ebtisam Bakhsh  3 , Aslam Pathan  1 , Mosaad Almegren  4
Affiliations
Review

Use of direct oral anticoagulants in daily practice

Feras Almarshad et al. Am J Blood Res. .

Abstract

In recent years, the options for anticoagulant therapy have examined new direct oral anticoagulants (DOACs) comprising direct thrombin inhibitors (dabigatran) and direct factor Xa inhibitors (rivaroxaban, apixaban, and edoxaban). These agents represent further progress towards the ideal anticoagulant drug and thus towards a safe and effective antithrombotic therapy. The ideal anticoagulant is oral and has a wide therapeutic range, predictable pharmacokinetics and pharmacodynamics, a rapid onset of action, an available antidote, minimal side effects, and minimal interactions with other drugs or food. This review addresses the practical considerations for physicians in DOAC use, including indication, dosage, monitoring, pharmacokinetic profile, drug-drug interaction, and reversal of direct anticoagulation effects in case of bleeding.

Keywords: DOACs; apixaban; dabigatran; edoxaban; reversal; rivaroxaban.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Management of bleeding in patient using DOAC.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Barnes GD, Ageno W, Ansell J, Kaatz S Subcommittee on the Control of Anticoagulation of the International Society on Thrombosis and Haemostasis. Recommendation on the nomenclature for oral anticoagulants: communication from the SSC of the ISTH. J Thromb Haemost. 2015;13:1154–6. - PubMed
    1. Kearon C, Akl EA, Ornelas J, Blaivas A, Jimenez D, Bounameaux H, Huisman M, King CS, Morris TA, Sood N, Stevens SM, Vintch JRE, Wells P, Woller SC, Moores L. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest. 2016;149:315–35. - PubMed
    1. Chai-Adisaksopha C, Hillis C, Isayama T, Lim W, Iorio A, Crowther M. Mortality outcomes in patients receiving direct oral anticoagulants: a systematic review and meta-analysis of randomized controlled trials. J ThrombHaemost. 2015;13:2012–20. - PubMed
    1. Schulman S, Kearon C, Kakkar AK, Mismetti P, Schellong S, Eriksson H, Baanstra D, Schnee J, Goldhaber SZ RE-COVER Study Group. Dabigatran versus warfarin in the treatment of acute venous thromboembolism. N Engl J Med. 2009;361:2342–52. - PubMed
    1. Kearon C, Kahn SR, Agnelli G, Goldhaber S, Raskob GE, Comerota AJ. Antithrombotic therapy for venous thromboembolic disease: American college of chest physicians evidence-based clinical practice guidelines (8th edition) Chest. 2008;133:454S–545S. - PubMed

LinkOut - more resources