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What are Direct-Acting Oral Anticoagulants (DOACs)?

You may know about anticoagulants as

“blood thinners” used to treat certain blood

vessel, heart and lung conditions, including

atrial fibrillation (AFib), peripheral artery

disease (PAD) and venous thromboembolism

(VTE). Anticoagulants keep blood clots from

forming in an artery, a vein or the heart, and

may prevent existing clots from getting larger.

In particular, they are prescribed for AFib

patients because their irregular heartbeats

can cause blood to collect in the heart and

form a clot that can travels to the brain,

cutting off the oxygen and blood supply

causing a stroke. About one in five people

who have a stroke has AFib.

The more conventional anticoagulants are

warfarin (Coumadin) and heparin. However,

DOACs are a class of newer medications that

may be more convenient medications to take

if you are a suitable candidate for them.

What are the advantages to taking a DOAC

versus other anticoagulants?

Traditional anticoagulants such as warfarin require

monthly blood tests, dietary considerations and careful

attention to the possibility of uncontrolled bleeding.

DOACs show to be highly effective yet require less

monitoring and may reduce the risk of brain bleed when

taken for stroke prevention. They also begin to work, and

clear the system when needed, quicker than warfarin.

What are the names of medications I may be

prescribed?

Some DOAC medications include:

• Apixaban (Eliquis®)

• Dabigatran (Pradaxa®)

• Rivaroxaban (Xarelto®)

• Edoxaban (Savaysa™)

What do I need to know about taking

DOACs?

Excessive bleeding is a risk for anyone on anticoagulants.

The effects of warfarin usually can be reversed with

vitamin K. Only one DOAC, dabigatran, currently has

a specific reversal agent to stop bleeding. However,

DOACs do not require as much blood monitoring and

have few drug and food interactions.

You should always:

• Keep an anticoagulant alert card with you at all times.

Carry it in your purse or wallet so it can be found

quickly and easily in case of emergency. You can cut

out, complete and use the one provided in this sheet.

• Tell any family members responsible for your care

and all healthcare providers that you are taking an

anticoagulant.

• Adhere to your medication regimen and do not abruptly

stop taking your DOACs without first talking with your

doctor. Doing so could actually increase your risk of

stroke.

• Plan ahead with your doctor when to stop taking your

DOACs if you are having surgery or a test such as a

colonoscopy.

Could this medication cause problems?

If you do as your doctor tells you, there probably won’t be

problems. But you must tell your doctor right away if:

Your urine turns red or dark brown. This could be a sign
of urinary tract bleeding.
• Your stools turn red, dark brown or black. This could be
a sign of intestinal bleeding.
• You bleed more than normal when you have your period.
• Your gums bleed.
• You have a very bad headache or stomach pain that
doesn’t go away.
• You get sick or feel weak, faint or dizzy.
• You think you’re
pregnant.
• You often find bruises
or blood blisters.
• You have an accident
of any kind.
You think you're pregnant.
You often find bruises or blood blisters.
You have an accident of any kind.

HOW CAN I LEARN MORE?

1. Call 1-800-AHA-USA1

(1-800-242-8721), or visit heart.org

to learn more about heart disease and

stroke.

2. Sign up to get Heart Insight, a free

magazine for heart patients and their

families, at heartinsight.org.

3. Connect with others sharing similar

journeys with heart disease and stroke

by joining our Support Network at

heart.org/supportnetwork.

Do you have questions for the doctor or nurse?

For example:

Am I a candidate for

DOACs?

Should I wear a medical

alert bracelet that

says I’m on a DOAC?

We have many other fact sheets to help you

make healthier choices to reduce your risk,

manage disease or care for a loved one. Visit

heart.org/answersbyheart to learn more

Boehringer Ingelheim supports the American Heart

Association’s efforts to improve AFib patient outcomes

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