apixaban + dabigatran + edoxaban + rivaroxaban

This is a combination of four direct oral anticoagulants (DOACs): apixaban, dabigatran, edoxaban, and rivaroxaban. Each agent acts as an anticoagulant but with distinct mechanisms within the coagulation cascade. Apixaban, edoxaban, and rivaroxaban are direct factor Xa inhibitors that prevent thrombin generation by selectively inhibiting factor Xa. Dabigatran is a direct thrombin (factor IIa) inhibitor that prevents the conversion of fibrinogen to fibrin. All four drugs are used for the prevention and treatment of thromboembolic disorders such as non-valvular atrial fibrillation (NVAF), deep vein thrombosis (DVT), pulmonary embolism (PE), and for stroke prevention in patients with atrial fibrillation[1][4][6]. These agents have largely replaced vitamin K antagonists in many clinical settings due to their predictable pharmacokinetics and reduced need for monitoring.

Brand names

PradaxaXareltoEliquisLixianaSavaysa

Other names

NOACsDOACsNon-vitamin K antagonist oral anticoagulantsDirect oral anticoagulants