[PRACTICAL ADVICE FOR THE APPROPRIATE USE OF DIRECT ORAL ANTICOAGULANTS]

Harefuah. 2019 Mar;158(3):200-204.
[Article in Hebrew]

Abstract

The direct oral anticoagulants (DOACs) are a class of drugs used for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation and for prevention and treatment of venous thrombo-embolism. They are as effective and are safer than the vitamin K antagonists that were the oral drugs previously used for this purpose. The DOACs are convenient to use because of their fixed dose-response relationship which makes routine monitoring of drug levels unnecessary. Further, they have no food interactions and relatively few drug interactions. A number of practical considerations related to the routine clinical use of the DOACs have become apparent. These include choosing the appropriate drug and importantly dose-based on patient characteristics, managing the use of DOACs peri-operatively and the appropriate management of the acutely bleeding DOAC-treated patient. Recent controlled and observational studies provide guidance for dealing with these clinical situations thus enhancing the efficacy and safety of DOAC treatment in routine clinical practice.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Anticoagulants* / adverse effects
  • Anticoagulants* / therapeutic use
  • Atrial Fibrillation* / drug therapy
  • Hemorrhage / chemically induced
  • Humans
  • Stroke* / prevention & control

Substances

  • Anticoagulants