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Clinical pharmacy 2024/2025 Level 3 Pharm D Pharmacology 1 (PO 502)
5- New Oral Anticoagulants

New oral anticoagulants (NOACs): Dabigatran, rivaroxaban, apixaban, edoxaban

Designed to
1) produce a predictable level of anticoagulation,

Description 2) rapid onset and offset of action,
3) more convenient to administer due to fixed doses without
routine coagulation monitoring

have shown non-inferiority and superiority to VKA;
NOCAs
VKA still standard of care for mechanical heart valve.
Drug Rivaroxaban Apixaban Edoxaban Dabigatran

Target Factor Xa Thrombin

Monitoring: No coagulation monitoring required, renal function

➢ Bleeding, less intracranial bleeding than VKA but more GI
Side Effects: bleeding.
 Dyspepsia (dabigatran)

Drug
Interactions Low potential, P-glycoprotein based, CYP3A4
Contraindication in pregnancy

 Reversal of Oral Anticoagulants

 Vitamin K (oral/injection), Prothrombin complex concentrate (PCC), FFPs, and
recombinant factor VIIa

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