Direct oral anticoagulants

For fifty years warfarin was the only available oral anticoagulant. This drug had a significant effect on the prognosis of the patients with

atrial fibrillation, venous thromboses and arteficial valve replacements. For the treatment of the patients with anarteficial valve replacement,

warfarin remains the only possibility, for the other indications several alternatives have recently emerged. The new oral anticoagulants

(NOACs) – dabigatran, rivaroxaban and apixaban – have some advantages compared to warfarin: simple and unitary dosage regimen, good

safety and no need for a regular effect monitoring. The NOACs have some specific characteristics, which vary substantially from warfarin

and parenteral low molecular weight heparins. The number of patients using NOACs rise quickly and so the patients more and more often

come to visit doctors with specializations, that do not directly prescribe the NOACs themselves and as such are not so often educated about

this topic by their professional associations and pharmaceutical companies. At least a basic knowledge of pharmacological characteristics

of the NOACs is essential even in these medical specialties, so that no harm to the patient is made due to an inappropriate choice of medical

treatment or interacting medicaments that could lead to severe thrombotic or hemorrhagic complications.

Keywords: novel aralanticoagulants, pharmacokinetics, druginteractions, dosage, adversereactions