NOACs (dabigatran, apixaban, rivaroxaban)

thrombin or factor Xa inhibitors

MoA:

• Rivaroxaban: directly inhibits FXa
• Apixaban: directly inhibits FXa
• Dabigatran: rapid-acting, reversible competitive inhibitor of both free and fibrin-bound thrombin, preventing conversion of fibrinogen to fibrin and preventing thrombus formation.
  • Thrombin-induced platelet aggregation is also inhibited.

Indications:

• Prevention of DVT, PE, stroke

Contraindications:

• Active bleeding or risk of active bleeding
• HIV protease inhibitors
• Concomitant Rx w/ other anticoags (LMWH, warfarin, etc.)
• Pregnancy  use heparin/LMWH

Route: PO