Switching of DOAC

 Q: Switching from one Direct Oral Anticoagulant (DOAC) to another should be done with a space of 48-72 hours?

A) True

B) False

Answer: B

Currently, there are four DOACs approved for use in the USA. 

• dabigatran 
• rivaroxaban 
• apixaban 
• edoxaban

Due to various reasons i.e., availability, insurance authorization, tolerance, or patient preference - clinicians may need to switch from one DOAC to another. The beauty is that one DOAC can be switched to another DOAC without any interruption or overlap. The second DOAC can be continued when the next dose of the first DOAC is due.

#hematology

#pharmacology

References:

1. Oyakawa T, Muraoka N, Iida K, Kusuhara M. Effect of Switching from the Initial Direct Oral Anticoagulant to Another One on Exacerbation of Venous Thromboembolism in Patients with Cancer: A Retrospective Study. Ann Vasc Dis. 2018;11(4):531-534. doi:10.3400/avd.oa.18-00072 

2. Marchetti G, Bernardini F, Romoli M, Urbinati S. Switching across direct oral anticoagulants: a real-life-setting pilot prospective study. J Cardiovasc Med (Hagerstown). 2021 Jun 1;22(6):453-458. doi: 10.2459/JCM.0000000000001118. PMID: 33186238.

3. Romoli M, Marchetti G, Bernardini F, Urbinati S. Switching between direct oral anticoagulants: a systematic review and meta-analysis. J Thromb Thrombolysis. 2021 Jan 2. doi: 10.1007/s11239-020-02367-2. Epub ahead of print. PMID: 33389613.