Laboratory measurement of the direct oral anticoagulants.
Direct oral anticoagulants (DOACs), including the direct thrombin inhibitor, dabigatran, and the direct factor Xa (FXa) inhibitors, rivaroxaban, apixaban and edoxaban, are approved for thromboembolism prevention and treatment. These drugs do not require routine coagulation monitoring but, in some circumstances, measurement of drug level or anticoagulant effect may be necessary. Although traditional coagulation tests lack analytical sensitivity and specificity, they are widely available and inexpensive, and can provide useful information regarding the residual anticoagulant effect of DOACs. Hemoclot® and ecarin-based assays can be used to quantify dabigatran level and calibrated chromogenic anti-FXa assays are suitable for measuring rivaroxaban, apixaban and edoxaban levels, but these tests are not yet widely available.
School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia.
Brian J
BJ
Dale
Population Health Research Institute, Hamilton, Ontario, Canada.
Noel C
NC
Chan
Population Health Research Institute, Hamilton, Ontario, Canada.|Department of Medicine, McMaster University, Hamilton, Ontario, Canada.|Thrombosis and Atherosclerosis Research Institute, Hamilton, Ontario, Canada.
John W
JW
Eikelboom
D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage / Q000494:pharmacology*; D001777:Blood Coagulation / Q000187:drug effects*; D001780:Blood Coagulation Tests / Q000379:methods*; D002851:Chromatography, High Pressure Liquid / Q000379:methods; D000069604:Dabigatran / Q000008:administration & dosage / Q000494:pharmacology; D016903:Drug Monitoring / Q000379:methods; D006801:Humans; D011720:Pyrazoles / Q000008:administration & dosage / Q000494:pharmacology; D011725:Pyridines / Q000008:administration & dosage / Q000494:pharmacology; D011728:Pyridones / Q000008:administration & dosage / Q000494:pharmacology; D000069552:Rivaroxaban / Q000008:administration & dosage / Q000494:pharmacology; D013844:Thiazoles / Q000008:administration & dosage / Q000494:pharmacology
D000925:Anticoagulants; D011720:Pyrazoles; D011725:Pyridines; D011728:Pyridones; D013844:Thiazoles; C522181:apixaban; D000069552:Rivaroxaban; D000069604:Dabigatran; C552171:edoxaban
anticoagulants; coagulation; drugs; laboratory haematology; thrombosis