Table 2.

Potential advantages and disadvantages of DOACs compared to VKAs [119]

Advantages	Disadvantages
No routine monitoring	No reliable, readily available measurement assay
Improved safety profile	Dose reduction or avoidance in renal impairment and avoidance in moderate or severe hepatic impairment
Rapid onset (may preclude the need for induction or bridging therapy)	No specific antidote
Short half-life (advantageous for invasive procedures or in the setting of active bleed)	Short half-life (mandates strict adherence)
Fixed dosing	Less flexibility in dosing
Greater convenience, patient satisfaction and quality of life	Fewer studies and approved indications (e.g., contraindicated in mechanical valve replacement)
Potentially more cost-effective from health system perspective	Potentially higher drug acquisition costs for patients
Fewer drug, disease and diet interactions	DOAC drug interactions do exist that may preclude use