Anticoagulants - NOACs

 

Pharmacokinetics:

 

Apixaban

Rivaroxaban

Dabigatran etexilate

Absorption

50%

100%

Bioav 6.5%

Liver activates prodrug

Distribution

90% PPB

90% PPB

35% PPB (low = dialysable)

Metabolism

Liver CYP (2/3)

Liver CYP (2/3)

Liver phase 2 (minimal)

Excretion

Urine (1/3)

Bile

Urine (1/3)

Bile

Urine (85%)

Half life

12 hours

6-12 hours

12-18 hours

 

Pharmacodynamics:

 

Apixaban

Rivaroxaban

Dabigatran etexilate

MoA

Xa inhibitor

Xa inhibitor

Thrombin inhibitor

Onset

30 mins

30 mins

30 mins

Duration

1 day

1 day

1-3 days

Coags

Normal

↑INR

↑aPTT

Monitoring

Xa

Xa

TCT (normal = no drug)

DTT

ECT

Antidote

Andexanet alpha

Ciraparantag

FEIBA*

Andexanet alpha

Ciraparantag

FEIBA*

Idarucizumab*

Ciraparantag

FEIBA*

*actually available

 

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