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Table 103.12

Comparison of Direct-Acting Oral Anticoagulants

DabigatranRivaroxabanApixaban
MechanismInhibition of IIaInhibition of XaInhibition of Xa
Onset of action2–3h post dose2–3h post dose2–3h post dose
Half-life12–17h7–9h9–14h
Metabolism20% hepatic; 80% renal75% hepatic; 25% renal75% hepatic; 25% renal
Effect on PT (at peak concentration)Normally <1.51.3–1.6Often normal
Effect on APTT (at peak concentration)Normally increasedAPTT ratio 1.4–1.6Normally some prolongation
Effect on thrombin time (TT)Very prolongedUnaffectedUnaffected
Measurement of anticoagulant effectModified thrombin timeAnti-Xa assaysAnti-Xa assays