Table 2.
Characteristics of VKA and DOACs.
| VKA [10] | Dabigatran Etexilate [24,27,28] | Rivaroxaban [30,31] | Apixaban [32] | |||
|---|---|---|---|---|---|---|
| Warfarin | Acenocoumarol | Phenprocoumon | ||||
| Target | Vitamin K epoxide reductase | Vitamin K epoxide reductase | Vitamin K epoxide reductase | Thrombin | Factor Xa | Factor Xa |
| Pro-drug | No | No | No | Yes, active metabolite is dabigatran | No | No |
| Half-life (hours) | 20–60 | 8–11 | 120–144 | 12–17 | 5–9 | 9–14 |
| Onset time peak effect (hours) | 72–96 | 36–48 | 48–72 | 2 | 2–3 | 3 |
| Duration of action | 2–5 days | <48 h | 7–14 days | 24–36 h | 24 h | 24 h |
| Metabolism | Via cytochrome P 450 | Via cytochrome P 450 | Via cytochrome P 450 | Via P-Glucoprotein transporter | Via cytochrome P450 (30%), and P-Glucoprotein transporter | Via cytochrome P450 (15%), and P-Glucoprotein transporter |
| Elimination | Hepatical metabolized | 60% Renal | 63% Renal | 85% Renal | 66% Renal | 25% Renal |
| 29% Fecal | 33% Fecal | 6% Fecal | 28% Fecal | |||
| Bioavailability | 79%–100% | 60% | >99% | 6.5% | 80% | 66% |