title: [New oral anticoagulants (NOAC) in nephrology].
abstract: The new or direct oral anticoagulants [new oral anticoagulants (NOAC) or direct oral anticoagulants (DOAC)] were launched in the Italian market in 2013. Although these compounds share common pharmacological indications with vitamin K antagonists (warfarin or acenocumarol), they have different mechanisms of action, do not require a constant anticoagulant monitoring but are more efficacious and safer than vitamin K antagonists. The use of these molecules (Dabigatran, Apixaban, Rivaroxaban, Betrixaban, Edoxaban) is constantly rising in daily practice. However, while available data suggest that NOAC/DOAC use is safe, dosage should be adjusted based on renal or liver function. It should be acknowledged that commonly available blood tests [Prothrombin Time (PT) and partial thromboplastin time (PTT)] are not indicated to monitor the anticoagulant activity of these compounds. With the exception of dabigatran, we currently lack of an antidote to reverse the anticoagulant effect of NOAC/DOAC. We herein review available evidence on NOAC/DOAC pharmacokinetic, risk factors for bleeding, interventions to reverse the anticoagulant activity in case of hemorrhages or need of urgent surgery and/or NOAC/DOAC overdose or side effects.
authors.forename: Antonio
authors.initials: A
authors.lastname: Bellasi
authors.forename: Luca
authors.initials: L
authors.lastname: Di Lullo
authors.forename: Gianvincenzo
authors.initials: G
authors.lastname: Melfa
authors.forename: Claudio
authors.initials: C
authors.lastname: Minoretti
authors.forename: Carlo
authors.initials: C
authors.lastname: Ratti
authors.forename: Carlo
authors.initials: C
authors.lastname: Campana
authors.forename: Maurizio
authors.initials: M
authors.lastname: Volpi
authors.forename: Stefano
authors.initials: S
authors.lastname: Mangano
authors.forename: Biagio
authors.initials: B
authors.lastname: Di Iorio
authors.forename: Mario
authors.initials: M
authors.lastname: Cozzolino
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D006801:Humans; D017410:Practice Guidelines as Topic; D006435:Renal Dialysis
chemical_list: D000925:Anticoagulants