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DOAC - Choosing between apixaban, rivaroxaban, dabigatran & edoxaban


Why this page is important: No trials have directly compared different DOACs with each other, but this table will enable you to determine which DOAC is best for your patient based on the patient's characteristics. 


Patient characteristics Advice DOAC recommended
Previous GI Bleed / disorder Chose agent/dose with fewer reported GO efects apixaban

High risk of bleeding, e.g. HAS‐BLED >3 or elderly patient

Consider agent/dose with the lowest incidence of bleeding (non specialists ‐ consider seeking advice) edoxaban, dabigatran110mg, apixaban
High risk of ischaemic stroke, low bleeding risk Consider agent/dose with the best reduction of ischaemic stroke dabigatran 150mg
Previous stroke (secondary prevention) Consider best investigated agent or greatest reduction of secondary stroke edoxaban, rivaroxaban, apixaban
CAD, previous MI or high‐risk for ACS/MI Consider agent with a positive effect in ACS rivaroxaban
Renal impairment Consider agent least dependent on renal function edoxaban 30mg (reduced dose), rivaroxaban 15mg, apixaban
Patient non-compliance Consider once daily dosing  edoxaban, rivaroxaban
Patient uses blister packs  Dabigatran & warfarin unsuitable  rivaroxaban apixaban edoxaban















apixaban dabigatran edoxaban rivaroxaban Warfarin

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