Direct-Acting Oral Anticoagulant Dos and Don'ts

Mayo Clinic physicians, Robert McBane, M.D., (Cardiology) and Ariela Marshall, M.D., (Hematology), discuss the new FDA drug watch list, specifically the direct-acting oral anticoagulants (DOACs).  For more information or to request an appointment, please Visit Here.
 

Direct-acting oral anticoagulants are a class of drugs that, although different in their action, are clinically similar.  DOACs can be used for stroke prevention in nonvalvular atrial fibrillation, venous thromboembolic (VTE) disease such as deep venous thrombosis or pulmonary embolism, or for clot prevention after orthopedic surgery such as a hip or knee replacement as well as many other conditions.

Benefits of DOACs are they do not need to be directly monitored, they tend to not interact with other medications, they are less painful and easier to use than other medications such as heparin, they are generally less expensive, and are fully therapeutic within 1 to 3 hours of taking them making them an attractive medication after major surgeries.  The most beneficial aspect of DOACs is the reduction in major bleeding. 

Patients who would not be good candidates for DOACs are those with mechanical hearts, antiphospholipid antibody syndrome, and patients who are pregnant.  Compliance with DOACs is extremely important just as it would be for patients undergoing regular INR monitoring.

Video Content Outline:

  • Introduction
  • Defining DOACs(0:30)
  • What are they used for
  • FDA approved indications
  • Defining differences among DOACs (2:13)
  • DOACs vs Warfarin (4:50)
  • Reversing bleeding in DOACs (7:50)
  • Candidates for DOACs and the importance of compliance (11:14)
  • Conclusion (18:08)

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Robert McBane, MD

Robert McBane, MD

Procedures performed Anticoagulant therapy Interests Vascular medicine Regulation of blood coagulation

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Ariela Marshall, MD

Ariela Marshall, MD

Conditions treated Arterial embolism Benign hematologic conditions Bleeding disorder Hemophilia Venous thrombosis von Willebrand disease Interests Hemostasis and thrombosis Hematologic disorders in pregnancy Women's ...

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