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Table 1 Characteristics of DOACs. Adapted from references [15,16,17,18,19]

From: Antiphospholipid Syndrome Committee of the Brazilian Society of Rheumatology position statement on the use of direct oral anticoagulants (DOACs) in antiphospholipid syndrome (APS)

Drugs

Mechanism of action

Brand name

Clinical indications

Half-life

Elimination

Drug interactions (see Table 2)

Dabigatran

Direct thrombin inhibitor

Pradaxa

- Non-valvular AFib;

12–14 h

Renal (80%)

- P-gp inducers

- Treatment of DVT and PE;

- P-gp inhibitors

- Reduction in the risk of recurrence of DVT and PE.

Rivaroxaban

Factor Xa inhibitor

Xarelto

- Non-valvular AFib;

5–13 h

Renal (67%)

- Combined P-gp and strong CYP3A4 inhibitors and inducers

- Treatment of DVT and PE;

- Reduction in the risk of recurrence of DVT and PE;

- Prophylaxis of DVT following hip or knee replacement surgery;

- Prophylaxis of DVT and PE in acutely ill medical patients;

- Risk reduction of major cardiovascular events in stable atherosclerotic vascular disease (in combination with ASA).

Apixaban

Factor Xa inhibitor

Eliquis

- Non-valvular AFib;

12 h

Faecal (56%)

- Strong dual inhibitors of P-gp and CYP3A4

- Treatment of DVT and PE;

- Prophylaxis of DVT following hip or knee replacement surgery.

Edoxaban

Factor Xa inhibitor

Savaysa (USA) / Lixiana (Brazil)

- Non-valvular AFib;

10–14 h

Renal (50%)

- P-gp inducers and inhibitors.

- Treatment of DVT and PE following 5–10 days of initial parenteral anticoagulation.

  1. AFib atrial fibrillation, ASA acetylsalicylic acid, BID twice daily, CrCl creatinine clearance, DVT deep vein thrombosis, PE pulmonary embolism, P-gp P-glycoprotein, QD once daily