Subcommittee on Control of Anticoagulation: When and how to use antidotes for the reversal of direct oral anticoagulants The direct oral anticoagulants (DOACs), which include dabigatran, rivaroxaban, apixaban, and edoxaban, are licensed for stroke prevention in patients with atrial fibrillation and for prevention and treatment of venous thromboembolism. As a class, the DOACs are at least as effective as vitamin K antagonists (VKAs), but are associated with less life-threatening bleeding, particularly intracranial hemorrhage. Although all anticoagulants can produce bleeding, the outcomes of major bleeds with DOACs are no worse than those with VKAs even in the absence of clinically available antidotes. Nonetheless, antidotes for the DOACs would be useful as one component of strategies for management of serious bleeding, or for rapid reversal of the DOACs prior to urgent interventions. Read more.