NOACs (Novel Oral Anticoagulants) or DOACs (Direct Oral Anticoagulants)

Currently there are four NOAC/DOACs available in the UK;

  • Rivaroxaban
  • Apixaban
  • Edoxaban
  • Dabigatran

The decision regarding which will be most appropriate can be made by your GP, local anticoagulation clinic or PH specialist centre.

How to take it

Your doctor or nurse should tell you how much of your anticoagulant medicine to take and when to take it. Most people need to take their tablets or capsules once or twice a day with water or food. The length of time you need to keep taking your medicine for depends on why it’s been prescribed. In the context of PH and especially CTEPH, treatment will be lifelong.

Do not take NOACs/DOACs if:
• You are allergic to either the medicine or any of the ingredients of the tablets.
• You are pregnant or breastfeeding.
• You have active clinically significant bleeding.
• Severe liver disease causing increased bleeding risk.

Side effects

DOACs work in a slightly different way to warfarin, however the precautions mentioned regarding warfarin will still apply. Due to the way some NOACs are cleared from the body, these can only be prescribed to patients with good kidney function. A baseline kidney function test may be needed to make sure NOACs would be safely eliminated from your system. Warfarin would be a safe alternative in patients unable to take NOACs due to kidney function.