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Research ArticleClinical Practice

The Direct Oral Anticoagulants Apixaban, Rivaroxaban, and Edoxaban

Keith Alan DeHaas
American Society for Clinical Laboratory Science January 2017, 30 (1) 2-6; DOI: https://doi.org/10.29074/ascls.30.1.2
Keith Alan DeHaas
Clinical Laboratory Science, Michigan State University, East Lansing, MI
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    Figure 1.

    Target Specificity of DOACs Compared to VKAs

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    Figure 2.

    Sites of Interaction between DOAC and factor Xa

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    Table 1.

    Overview of Selected Oral Anticoagulant Agents in the U.S.

    DrugRivaroxabanApixabanEdoxaban
    Mech. of actionFactor Xa inhibitorFactor Xa inhibitorFactor Xa inhibitor
    ProdrugNoNoNo
    Bioavailability66 – 100% (dose dependent)50%62%
    Protein Binding92 – 95%87%40 – 50%
    Coagulation Monitoring RequiredNoNoNo
    Half-life (hours)5 - 9125.8 – 10.7
    EliminationRenal and HepaticRenal and HepaticRenal and Hepatic
    Renal Dose AdjustmentYesYesYes (based on clinical trials)
    Drug InteractionsSubstrate of CYP450 3A4/5, 2J2 and P-gpSubstrate of CYP450 3A4/5, and P-gpSubstrate of P-gp
    Reversal Agent ApprovedNoNoNo
    DialyzableNot expectedNot expectedData not available
    IndicationsReduce stroke and systemic embolism in nonvalvular AF; treatment of DVT or PE or prevention of their recurrence; prophylaxis of DVT in those undergoing hip or knee surgeryReduce stroke and systemic embolism in nonvalvular AF; treatment of DVT or PE or prevention of their recurrence; prophylaxis of DVT in those undergoing hip or knee surgeryReduce stroke and systemic embolism in nonvalvular AF; treatment of DVT or PE or prevention of their recurrent, symptomatic VTE
    • A comparison and summary of selected characteristics of the direct oral anticoagulants Rivaroxaban, Apixaban and Edoxaban

    • AF = atrial fibrillation, DVT = deep vein thrombosis, PE = pulmonary embolism; P-gp = P=glycoprotein; VTE = venous thromboembolism Adapted from (2) with permission of authors.

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American Society for Clinical Laboratory Science: 30 (1)
American Society for Clinical Laboratory Science
Vol. 30, Issue 1
Winter 2017
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The Direct Oral Anticoagulants Apixaban, Rivaroxaban, and Edoxaban
Keith Alan DeHaas
American Society for Clinical Laboratory Science Jan 2017, 30 (1) 2-6; DOI: 10.29074/ascls.30.1.2

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The Direct Oral Anticoagulants Apixaban, Rivaroxaban, and Edoxaban
Keith Alan DeHaas
American Society for Clinical Laboratory Science Jan 2017, 30 (1) 2-6; DOI: 10.29074/ascls.30.1.2
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