PT  - JOURNAL ARTICLE
AU  - Bukhari, Syed
AU  - Ghoweba, Mohamed
AU  - Khan, Syed Zamrak
AU  - Saati, Ammar
AU  - Gomes, Marcelo
TI  - Direct oral anticoagulants: Challenging prescribing scenarios in everyday practice
AID  - 10.3949/ccjm.92a.24061
DP  - 2025 Jun 01
TA  - Cleveland Clinic Journal of Medicine
PG  - 353--361
VI  - 92
IP  - 6
4099  - http://www.ccjm.org/content/92/6/353.short
4100  - http://www.ccjm.org/content/92/6/353.full
SO  - Cleve Clin J Med2025 Jun 01; 92
AB  - Direct oral anticoagulants (DOACs) are preferred to vitamin K antagonists for treating venous thromboembolism and nonvalvular atrial fibrillation, primarily because of comparable efficacy, consistent dosing, and fewer drug-drug interactions. However, major trials that led to the approval of DOACs excluded subsets of patients who are challenging to treat in the primary care setting, including patients with extreme body weight, advanced kidney disease, and advanced cirrhosis, and those who have undergone bariatric surgery. The authors review the available evidence and outline current recommendations to help guide the appropriate use of DOACs in these patients.