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Direct-acting oral anticoagulants: bleeding risk and reversal agents

Direct-acting oral anticoagulants: bleeding risk and reversal agents

The use of direct-acting oral anticoagulants (DOACs) in the UK has been increasing.(1) One of the risks associated with their use is the increased risk of a potentially life-threatening or even fatal bleeding event.(1)

What are direct-acting oral anticoagulants?

DOACs are newer anticoagulant drugs: apixaban, dabigatran, edoxaban and rivaroxaban.(1) They are also known as NOACs – novel/new oral anticoagulants or non-vitamin K antagonist oral anticoagulants.(2) All of these terms encompass both direct thrombin inhibitors and direct factor Xa inhibitors. Of the available DOACs in the UK, dabigatran etexilate (Pradaxa) is the only direct thrombin inhibitor and apixaban (Eliquis), edoxaban (Lixiana) and rivaroxaban (Xarelto) are direct factor Xa inhibitors.(1)

How do DOACs work?

DOACs work by inhibiting specific enzymes involved in the coagulation

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