4 Direct Oral Anticoagulants Free Online FlashCards

Which direct oral anticoagulants inhibit factor Xa, and which inhibits thrombin?

Apixaban, rivaroxaban, and edoxaban inhibit factor Xa; dabigatran directly inhibits thrombin.

What are common uses of direct oral anticoagulants?

Depending on the drug and patient, they may prevent stroke in nonvalvular atrial fibrillation, treat or prevent recurrent DVT or PE, and prevent some postoperative venous clots.

Are DOACs appropriate for patients with mechanical heart valves?

No. DOACs are not appropriate for every patient or indication; mechanical heart valves require a different anticoagulation approach.

How should rivaroxaban for atrial fibrillation be taken?

Rivaroxaban doses used for atrial fibrillation are taken once daily with the evening meal.

How should dabigatran capsules be taken?

Swallow dabigatran capsules whole; opening or chewing them can increase drug exposure.

How do DOACs differ in starting treatment for acute DVT or PE?

Apixaban and rivaroxaban have initial oral treatment regimens. Dabigatran and edoxaban generally require an initial course of parenteral anticoagulation.

How can P-gp or CYP3A4 inhibitors and inducers affect DOACs?

An inhibitor may increase DOAC exposure, while an inducer may decrease it. The appropriate action depends on the specific drugs and the patient's kidney function.

Is INR used routinely to adjust DOAC doses?

Routine INR testing is not used to titrate DOAC doses.

What should routine follow-up assess for a patient taking a DOAC?

Periodically review adherence, bleeding or clotting symptoms, medications, CBC, kidney function, and liver function; assess more often when clinical status or renal function warrants.

Can standard PT/INR or aPTT reliably measure the anticoagulant effect of DOACs?

Standard PT/INR or aPTT results do not reliably quantify anticoagulant effect across DOACs. Specialized drug-calibrated assays may be considered in selected urgent situations.

What specifically reverses dabigatran?

Idarucizumab is the specific reversal agent for dabigatran in life-threatening or uncontrolled bleeding and when urgent procedures require reversal.

What is the U.S. availability status of andexanet alfa as of 2026?

Andexanet alfa was previously approved for apixaban- or rivaroxaban-associated life-threatening or uncontrolled bleeding, but U.S. commercial sales ended in December 2025.