Do not prescribe Vitamin K Antagonists if the patient has no contraindication to the use of direct oral anticoagulants (DOACs).

Type of practice


Topic Area


The different mechanism of direct oral anticoagulants (DOACs) compared to traditional oral anticoagulant therapy explains the better risk/benefit ratio of these drugs associated with a reduction of intracranial bleeding in different clinical settings (atrial fibrillation, venous thromboembolism, chronic ischemic heart disease and peripheral arterial disease) and in different types of patients, including frail ones (elderly, cancer, perioperative period) and with different comorbidities (renal failure, arterial hypertension, diabetes mellitus, heart failure).


1. Steffel J et al; 2021 European Heart Rhythm Association Practical Guide on the Use of Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation; Eur Heart J 2021: 23, 1612–1676
2. Harel Z, Sood MM, Perl J et al. Comparison of novel oral anticoagulants versus vitamin K antagonists in patients with chronic kidney disease. Current opinion in nephrology and hypertension 2015 Mar;24(2):183-92
3. Vílchez JA, Gallego P, Lip GY et al. Safety of new oral anticoagulant drugs: a perspective. Therapeutic advances in drug safety 2014 Feb;5(1):8-20



Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.