Uncontrolled bleeding (most serious side effect)Īnimal studies of some DOACs suggest the potential for fetal harm, so pregnant women and those planning a pregnancy should discuss LMWH as the preferred therapy with their doctor.Īs with all blood thinners, patients should avoid aspirin and other NSAIDS and wear or carry identification stating that they are taking anticoagulants.Premature discontinuation of apixaban or any oral anticoagulant increases the risk of thrombotic events.Potential Side Effects of Direct Oral Anticoagulant Medications Not all DOACs have FDA-approved antidotes in case of complications.Twice-daily dosing may increase chance for non-compliance.More expensive blood thinners than warfarin.Fewer drug, supplement and dietary interactionsĭisadvantages of Direct Oral Anticoagulant Medications.Advantages of Direct Oral Anticoagulant Medications Physicians can use prothrombin complex concentrate in emergency situations involving blood thinners that do not have a specific reversal agent yet approved by FDA. Ongoing studies are confirming its efficacy in reversing the other DOACs on the market betrixaban (BevyxXa®) and edoxaban (Savaysa®) as well as the low molecular weight heparin enoxaparin (Lovenox®) and fondaparinux (Arixtra®). On May 4 th 2018, FDA approved andexanet alfa (AndexXa®) for the reversal of apixaban (Eliquis®) and rivaroxaban (Xarelto®). In 2015 the FDA approved idarucizumab (Praxbind®) for reversal of dabigatran (Pradaxa®). One important concern of patients and physicians has been that there was no specific antidote for DOACs.
In addition, some DOACs require twice-daily dosing that, when compared to warfarin’s once-per-day administration, may lead to more missed doses. However, DOACs tend to be more expensive than warfarin and are shorter acting, making it important not to miss any doses, as this can quickly expose patients to inadequate protection against blood clot formation. Unlike warfarin, DOACs do not require regular laboratory monitoring and are not affected by food or alcohol. Others are in various stages of clinical study.ĭOACs are an alternative choice for blood clot treatment in appropriately selected patients. Available medications in this category include apixaban (Eliquis®), betrixaban (BevyxXa®), dabigatran (Pradaxa®), edoxaban (Savaysa®) and rivaroxaban (Xarelto®).
They are considered to be at least as effective as warfarin. These medications directly inhibit the blood’s ability to form blood clots.ĭOACs are both rapid and short-acting agents with relatively low bleeding risks and good overall safety profiles. Unlike warfarin these drugs do not require regular blood monitoring. Several direct oral anticoagulants (DOACs) have been approved by the United States Food & Drug Administration (FDA) since 2010. Home / About Clots / Blood Clot Treatment / Direct Oral Anticoagulants (DOACs) Direct Oral Anticoagulants (DOACs)
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