Direct%2525252525252525252525252525252525252525252520oral%2525252525252525252525252525252525252525252520anticoagulants

# Direct Oral Anticoagulants ## Overview Direct oral anticoagulants (DOACs) are a class of anticoagulant medications that directly inhibit specific factors in the coagulation cascade. They offer predictable pharmacokinetic and pharmacodynamic profiles, allowing for fixed dosing without routine laboratory monitoring in most patients. ## Primary Indications * Treatment and prevention of venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE). * Prevention of stroke and systemic embolism in non-valvular atrial fibrillation (NVAF). * Prevention of VTE in patients who have undergone hip or knee replacement surgery. ## Adult Dosing Specific dosing depends on the agent, indication, and patient factors. Refer to product labeling for precise dosing. * **Apixaban (Eliquis):** * NVAF: 5 mg twice daily. Reduced to 2.5 mg twice daily if at least two of the following criteria are met: age ≥ 80 years, body weight ≤ 60 kg, or serum creatinine ≥ 1.5 mg/dL. * VTE Treatment & Prevention: 10 mg twice daily for 7 days, followed by 5 mg twice daily. * VTE Prophylaxis (hip/knee replacement): 2.5 mg twice daily, starting 12-24 hours after surgery. * **Dabigatran (Pradaxa):** * NVAF: 150 mg twice daily. Reduced to 75 mg twice daily if CrCl is 15-30 mL/min or in patients ≥ 75 years or on P-glycoprotein inhibitors like verapamil. * VTE Treatment & Prevention: 150 mg twice daily after an initial 5-day treatment with parenteral anticoagulant. * VTE Prophylaxis (hip/knee replacement): 110 mg on the day of surgery, then 220 mg once daily for 10 days