Introduction
Mechanism of action
Dabigatran | Rivaroxaban | Apixaban | |
---|---|---|---|
Mechanism of action | Direct thrombin inhibitor | Direct factor Xa inhibitor | Direct factor Xa inhibitor |
Route | Oral | Oral | Oral |
Excretion | Majority renal | Majority liver | Majority faecal |
Indications
Dabigatran | Rivaroxaban | Apixaban | |
---|---|---|---|
UK brand name | Pradaxa | Xarelto | Eliquis |
NICE indications | Prevention of VTE following hip/knee surgery Treatment of DVT and PE Prevention of stroke in non-valvular AF* | Prevention of VTE following hip/knee surgery Treatment of DVT and PE Prevention of stroke in non-valvular AF* | Prevention of VTE following hip/knee surgery Treatment of DVT and PE Prevention of stroke in non-valvular AF* |
*NICE stipulate that certain other risk factors should be present. These are complicated and differ between the DOACs but generally require one of the following to be present:
- Prior stroke or transient ischaemic attack
- Age 75 years or older
- Hypertension
- Diabetes mellitus
- Heart failure