Direct oral anticoagulants and their clinical management

Thrombotic disorders are treated mostly with Heparin and Warfarin in cases requiring anticoagulation drugs. Due to limitations to these drugs including risk of bleeding and need for regular laboratory monitoring several Direct oral anticoagulants (DOACs) have been developed and shown to have more advantages than Warfarin. Nevertheless, these drugs are limited to use in some circumstances. As other anticoagulants, these drugs need to be managed and controlled to cope their over activities. Subsequently, many antidotes have been developed to reverse these DOACs. However, these antidotes are still understudies and need to be fully approved. The assessment of DOACs is developing and several drug-specific calibrators have been developed to measure DOACs activity in plasma.