New Oral Anticoagulants - NAO: What They Are and How They Work

- which indirectly inhibit the coagulation process, the NAOs perform their action by acting directly on the factors involved in the coagulation process and, more precisely, on thrombin (or factor IIa) and factor Xa.


  • The "apixaban;
  • L "edoxaban;
  • The dabigatran.
  • Note: by clicking on the name of each active principle it is possible to access the specific article dedicated to it.

    to all intents and purposes, NAOs are used in cases where it is necessary to prevent the formation of blood clots.

    Examples of therapeutic indications of NAOs are:

    • The prevention of venous thromboembolism;
    • The prevention and treatment of deep vein thrombosis and pulmonary embolism;
    • The prevention of blood clot formation in the brain;
    • The prevention of thrombus formation in patients undergoing certain surgeries;
    • The prevention of clot formation in the veins of the legs and lungs.

    In any case, each active principle belonging to the group of new oral anticoagulants can have different therapeutic indications, which also vary according to the dosage to which it is administered. For this reason, for more detailed information, please refer to the articles dedicated to each active ingredient on this site.

    . Depending on the type of factor inhibited, they can be divided into two groups. We can, therefore, distinguish:

    • Direct factor Xa inhibitors: belong to this group l "apixaban, L"edoxaban and the rivaroxaban. They act by binding selectively - albeit reversibly - to the coagulation factor Xa which is involved in the synthesis of factor IIa (or thrombin if you prefer), with a consequent increase in the clotting time.

    Apixaban appears to be the most potent inhibitor of all the NAOs in this group.

    • Direct factor IIa inhibitors: the dabigatran. The latter acts by binding in a highly selective manner - albeit reversibly - to thrombin or factor IIa which, in the coagulation process, is responsible for the splitting of fibrinogen into fibrin and for the conversion of coagulation factor XIII into factor XIIIa. The latter, in turn, favors the formation of the fibrin network that will trap the blood cells giving rise to the clot.
    to different organs and tissues (risk which, however, seems to be lower than that induced by traditional oral anticoagulants);
  • Itching, rashes and other skin disorders;
  • Nausea and other possible gastrointestinal disorders;
  • Anemia;
  • Possible changes in liver function tests;
  • Allergic reactions in sensitive individuals.
  • For more detailed information, see the articles dedicated to each NAO.

    constitute real contraindications. Therefore, if treatment with new oral anticoagulants becomes necessary, pregnant women and breastfeeding mothers must necessarily inform their doctor of their condition.

    and / or contact your doctor or pharmacist.

    For further information: Anticoagulant Drugs: What They Are Used For, Mechanism of Action, Side Effects

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