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Direct oral anticoagulants: a guide for daily practice
Pierre Fontana1, Helia Robert-Ebadi1, Henri Bounameaux1
1Division of Angiology and Haemostasis, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
Swiss Medical Weekly
|March 11, 2016
Summary
Direct oral anticoagulants (DOACs) like apixaban and rivaroxaban offer alternatives to older anticoagulants. This review provides practical guidance for clinicians on managing these novel antithrombotic agents safely and effectively.
Area of Science:
- Pharmacology
- Cardiology
- Hematology
Background:
- Direct oral anticoagulants (DOACs) targeting Factor Xa (FXa) or thrombin (FIIa) are now alternatives to traditional anticoagulants.
- DOACs represent a significant advancement in managing venous thromboembolic disease and atrial fibrillation.
Purpose of the Study:
- To offer practical suggestions for prescribing and using DOACs in daily clinical practice.
- To enhance physician confidence and ensure safer use of these novel antithrombotic agents.
Main Methods:
- A narrative review synthesizing clinical experience and updated recommendations from major scientific organizations.
- Focus on frequently asked questions to experienced specialists in the field.
Main Results:
- Addresses key aspects of DOAC management including pharmacokinetics, dosing, and side effects.
- Covers drug interactions, switching protocols, renal function considerations, and perioperative management.
- Discusses monitoring and reversal strategies, incorporating recent developments.
Conclusions:
- This review aims to assist physicians in the practical management of DOACs.
- Provides evidence-based insights for optimizing patient care with these newer anticoagulants.
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