Table 1.

Selected antithrombotic drugs.

Drug	Elimination	Risk	Comments
Anticoagulants
Direct Xa inhibitors ○ Apixaban ○ Betrixaban ○ Edoxaban ○ Rivaroxaban	○Fecal, 25% kidneys ○Hepatobiliary system ○Primarily via kidneys ○2/3 liver, 1/3 kidneys	○Major bleeding ○Discontinued ○Bleeding ○Bleeding	Approved  •Prevention of stroke  •Prevention of systemic embolism in nonvalvular atrial fibrillation  •Prevention of DVT and PE  •Prevention of recurrent DVT and PE following initial treatment
Direct thrombin inhibitors ○ Argatroban ○ Bivalirudin ○ Dabigatran ○ Desirudin ○ Hirudin	○Primarily fecal, kidney ○Proteolytic cleavage, 20% kidneys ○Fecal, 85% kidneys ○Primarily via kidneys ○Primarily via kidneys	○Bleeding ○Bleeding ○Bleeding ○Bleeding ○Severe bleeding	Approved  •Stroke prevention in nonvalvular atrial fibrillation  •VTE prophylaxis
Indirect thrombin inhibitors ○ Dalteparin ○ Enoxaparin ○ Fondaparinux ○ Heparin-unfractionated	○Liver, GI, 20% kidneys ○Primarily via kidneys ○Primarily via kidneys ○Primarily via reticuloendothelial system		Approved   •To treat and prevent thrombotic disorders (DVT, atrial fibrillation, PE)   •Acute coronary syndrome   •Heparin-induced thrombocytopenia (HIT)   •DVT and PE
Vitamin K antagonists ○ Warfarin	○92% via kidneys		Approved   •For the prevention and treatment of venous and arterial thrombosis
Antiplatelets
COX inhibitors ○ Aspirin ○ Other NSAIDs	○Mainly via kidneys		Approved   •Thromboembolic events   •Acute coronary syndrome   •Acute ischemic stroke   •Post percutaneous coronary intervention (PCI)   •Reduce the risk of heart attack
GPIIb/IIIa inhibitors ○ Abcixvimab ○ Eptifibatide ○ Tirofiban	○Mainly via kidneys ○50% via kidneys ○65% kidneys, 25% fecal	○Bleeding
P2Y12 inhibitors ○ Cangrelor ○ Clopidogrel ○ Prasugrel ○ Ticagrelor ○ Ticlopridine	○Primarily via kidneys ○50% kidneys, 45% fecal ○70% kidneys, 25% fecal ○Primarily via liver ○60% kidneys, 23% fecal
Phosphodiesterase inhibitors ○ Cilostazol ○ Dipyridamole	○Primarily by metabolism, 95% liver
Thrombolytics Plasminogen activators ○ Retallies ○ Streptokinase ○ Tissue plasminogen activator	○Primarily by liver ○Primarily by liver ○Primarily by liver		Approved   •The emergency treatment of stroke and heart attack   •Acute PE   •Ischemic stroke   •Myocardial infarction