Table 1.

Summary of pharmacokinetic and pharmacodynamic properties of commonly used oral anticoagulants

OACTypeProdrugPharmacokineticsPharmacodynamics: Binding to Effector
MetabolismRenal Dose AdjustmentDialyzable
WarfarinVitamin K–dependent factor inhibitorNoExtensive metabolism by CYP2C9NoNoIrreversible
DabigatranDirect thrombin inhibitorYesMetabolized by esterases, 80% excreted by kidneyYesYesReversible
ApixabanFree and clot-bound Xa inhibitorNoMetabolized in liver by CYP3A4, then excreted in feces and kidney (25%), no active metaboliteNoSmallReversible
RivaroxabanFree and clot-bound Xa inhibitorNo66% Excreted by kidney, 36% unchanged, minimal in fecesYesNoReversible
EdoxabanFree Xa inhibitorNo50% Excreted unchanged by the kidney, 10% hydrolyzed by carboxyesterase 1YesNoReversible
  • OAC, oral anticoagulant; CYP2C9, cytochrome P450 type 2C9; Xa, factor Xa; CYP3A4, cytochrome P450 type 3A4.