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Pharmacokinetics and Pharmacodynamics of DOAC

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Direct Oral Anticoagulants

Abstract

Direct oral anticoagulants (DOACs) have become available as an alternative to warfarin anticoagulation in non-valvular atrial fibrillation. The DOACs, dabigatran (a reversible direct thrombin inhibitor) and the direct factor Xa inhibitors rivaroxaban, apixaban, and edoxaban offer fixed dosing, more predictable pharmacokinetics and fewer interactions with drugs and food than warfarin. Results from clinical trials demonstrated an improved benefit-risk ratio, compared to warfarin, in a broad patient population. However, significant differences between the four DOACs in terms of pharmacokinetic and safety profile are observed and must be considered to personalize the therapy.

Thus, in the present chapter are described the pharmacodynamic and pharmacokinetic characteristics of DOACs, parameters that can help to differentiate their use based on the patient’s characteristics. Such condition should also guide clinicians to prescribe the appropriate type and dosage of DOAC, without the laboratory monitoring of their anticoagulant activity.

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Authors and Affiliations

  1. Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy

    Nicola Ferri

Authors
  1. Nicola Ferri
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Correspondence to Nicola Ferri .

Editor information

Editors and Affiliations

  1. Cardiac Rehabilitation Unit Ospedale, Sacra Famiglia Fatebenefratelli, Erba, Italy

    Riccardo Proietti

  2. McGill University, Montreal, QC, Canada

    Ahmed AlTurki

  3. Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padova, Italy

    Nicola Ferri

  4. Department of Medical Translational Sciences, University of Campania “Luigi Vanvitelli” - Monaldi Hospital, Naples, Italy

    Vincenzo Russo

  5. Division of Cardiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA

    T. Jared Bunch

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Ferri, N. (2021). Pharmacokinetics and Pharmacodynamics of DOAC. In: Proietti, R., AlTurki, A., Ferri, N., Russo, V., Bunch, T.J. (eds) Direct Oral Anticoagulants. Springer, Cham. https://doi.org/10.1007/978-3-030-74462-5_3

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  • DOI: https://doi.org/10.1007/978-3-030-74462-5_3

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-74461-8

  • Online ISBN: 978-3-030-74462-5

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