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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