Table 6.

Mechanism of action and pharmacological characteristics of DOACs.

	Dabigatran	Rivaroxaban	Apixaban	Edoxaban
Mechanism	Oral direct reversible competitive thrombin antagonist	Oral direct reversible competitive factor Xa antagonist	Oral direct reversible competitive factor Xa antagonist	Oral direct reversible competitive factor Xa antagonist
CYP3A4 substrate	No	Yes	Yes	Yes
Metabolism	Glucoronic acid conjugation	CYP3A4, CYP2J2	CYP3A4/5, CYP1A2, CYP2C8, CYP2C9, CYP2C19	CYP3A4/5
Bioavability	3%–7%	66% without food, 80%–100% with food	50%	62%
Prodrug	Yes	No	No	No
Absorption with food	No effect	39%	No effect	6%–22%
Clearance non renal/renal	20%–80%	35%–65%	73%–27%	50%–50%

CYP, cytochromes P450; Factor Xa, activated coagulation factor X; DOACs, direct oral anticoagulants.