Warfarin vs. Direct Oral Anticoagulants

Direct oral anticoagulants, or DOACs, include apixaban, rivarelbana, edoxaban, and dabigatran. Unlike warfarin, DOACs target specific clotting factors directly: apixaban and rivaroxaban inhibit factor ten-a, while dabigatran inhibits thrombin. DOACs do not require routine INR monitoring, have fewer food and drug interactions, and have more predictable dosing than warfarin. However, DOACs are more expensive and cannot be used with mechanical heart valves. Specific reversal agents exist: idarucizumab for dabigatran and andexanet alfa for factor ten-a inhibitors.