Warfarin overdoses, on the other hand, are mitigated with vitamin K and clotting factor administration. 3 Although they comprise a promising group of medications, the DOACs initially had no reversal agents. 4įrom 2009 to 2014, DOAC treatment visits in the United States exceeded a million patients per quarter, a figure that is similar to the number of visits by warfarin patients.

Most importantly, they have obviated the need for frequent testing of the international normalized ratio (INR) as is required with patients taking VKAs. 3 More recently, direct oral anticoagulants (DOACs), such as dabigatran, rivaroxaban, apixaban, edoxaban, and betrixaban, have made their way onto the market and have shown comparable or greater efficacy, a desirable safety profile, and relatively simple dosing regimens compared to the VKAs. 2 For decades, vitamin K antagonists (VKAs) have been the traditional and only oral anticoagulant option but using them can be challenging owing to nuances in monitoring, dosing, and drug interactions. Atrial fibrillation is the most common type of arrhythmia, affecting approximately 2.7 to 6.1 million people in the United States, 1 and VTE affects about another 900,000 people each year. Oral anticoagulants are the medication of choice for the prevention of stroke in atrial fibrillation (AF) and the treatment of venous thromboembolism (VTE).

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