Anna Remková, Milan Remko
The clinical use of existing older anticoagulants such as vitamin K antagonists (VKA) is limited by the required anticoagulation monitoring, the narrow therapeutic window, and numerous food and drug interactions. A number of novel oral anticoagulants, including direct thrombin inhibitors (dabigatran) and direct factor Xa inhibitors (rivaroxaban, apixaban), have been developed and are now becoming available in clinical practice. They have a relatively short half-life, acceptable therapeutic window, predictable dose–response relationship and no need for regular laboratory monitoring and dose-adjustment. As a result of all these characteristics, they are much more manageable than heparins or VKAs. Following the completion of phase III clinical trials and the recent approval by the regulatory agencies, they can be prescribed for treatment and prophylaxis of thrombotic events, thus opening a new era in antithrombotic treatment.