An update on applications and limitations of direct oral anticoagulants

Abstract

A major advancement in the field of medicine has been the introduction and usage of direct oral anticoagulants (DOACs) such as dabigatran (Pradaxa), apixaban (Eliquis), and rivaroxaban (Xarelto). DOACs have been increasing in popularity for mainstay anticoagulation pharmacotherapy and are being preferred by physicians over warfarin due to their rapid onset, fewer drug and food interactions, and lack of frequent blood monitoring. DOACs have been indicated in the management of thromboembolic conditions and have been extensively researched in various medical trials and studies before the approval of dabigatran (Pradaxa) in 2010 by the FDA. DOACs, like warfarin, are associated with a risk of bleeding, requiring clearance of the drug from the bloodstream or administration of reversal agents. It is important for physicians to familiarize themselves with the various types of DOACs and their dosages, along with their advantages and disadvantages in comparison to other non-DAOC classes of medications before incorporating them into their patient management plans.

Non-traumatic Subcapsular Hematoma of the Liver in a Patient under Rivaroxaban: A Rare Clinical Occurrence

“…Temporary or permanent cessation of anticoagulant treatment with DOACs is a therapeutic option, this decision takes into account the type of bleeding (major or CRNMB) [6]. In the event of uncontrolled major bleeding, recourse to neutralizing agents and antidotes (Idarucizumab, Adexanat, PCC) can be a therapeutic option [6,26,27], without forgetting hemodialysis in the event of treatment with Dabigatran [6,26].…”