Comparison of Direct-Acting Oral Anticoagulants
Dabigatran | Rivaroxaban | Apixaban | |
---|---|---|---|
Mechanism | Inhibition of IIa | Inhibition of Xa | Inhibition of Xa |
Onset of action | 23h post dose | 23h post dose | 23h post dose |
Half-life | 1217h | 79h | 914h |
Metabolism | 20% hepatic; 80% renal | 75% hepatic; 25% renal | 75% hepatic; 25% renal |
Effect on PT (at peak concentration) | Normally <1.5 | 1.31.6 | Often normal |
Effect on APTT (at peak concentration) | Normally increased | APTT ratio 1.41.6 | Normally some prolongation |
Effect on thrombin time (TT) | Very prolonged | Unaffected | Unaffected |
Measurement of anticoagulant effect | Modified thrombin time | Anti-Xa assays | Anti-Xa assays |