DOAC

Question 1

Class

Answer 1

Anticoagulant

Question 2

Contraindications

Answer 2

• Significant renal impairment
  – Significant risk of major bleeding
  – Active bleeding

Question 3

How it works

Answer 3

– Thins the blood to treat or prevent blood clots
– Many proteins are involved in blood clot formation – this medication blocks one of these proteins from working

Question 4

Treatment course and how it’s taken

Answer 4

– Once or twice daily tablet/capsule
– Take with full glass of water whilst sitting upright
– Usually prescribed for 3 months for a DVT, 6 months for a PE, and lifelong for AF

Question 5

Monitoring required

Answer 5

• None
• Renal function before and anually

Question 6

Side effects

Answer 6

– Bleeding
– GI disturbance
– Irreversible if serious bleed occurs (except dabigatran)

Question 7

Safety-netting

Answer 7

– seek medical advice if you double dose OR have a significant head injury, prolonged nose bleeds, unusual headaches, blood in urine/stool/vomit, black stool, unexplained or severe bruising

Question 8

Missed doses

Answer 8

Apixaban or dabigatran (BD) take as soon as possible, as long as >6hrs until next dose. if <6hrs, skip that dose then wait and take next dose

Rivaroxaban OD take as soon as possible, as long as >12hrs until next dose. if <12hrs, skip that dose then wait and take next dose

Edoxaban OD - take it as soon as you remember. If you only remember the following day, skip the missed dose, and take your next dose at the usual time. Never take more than 1 dose of edoxaban in a single day.

If you accidentally take more than your prescribed dose of apixaban, dabigatran, rivaroxaban or edoxaban, contact your GP or anticoagulant clinic for advice. Taking too much puts you at risk of bleeding.