2.3.2.2 Factor Xa inhibitors - includes DOACs

Direct Oral Anticoagulants (DOACs) are recommended as first line treatment over Vitamin K antagonists (Warfarin) for treatment in newly initiated patients with non-valvular atrial fibrillation (NVAF) as per NICE NG196. Apixaban or Rivaroxaban (prescribed generically) is recommended as first line (preferred) DOAC in newly diagnosed patients with NVAF, unless contraindicated, not tolerated or clinically inappropriate.
Please see Anticoagulant Prescribing - Kent and Medway ICB Position Statement and Risk Mitigation Principles for Anticoagulant Prescribing, for advice on cost-effective choice of DOAC 

For Kent and Medway DOAC Monitoring Recommendations for Non-Valvular
Atrial Fibrillation (NVAF) in Primary Care Click Here

For SPS Guidance on Apixaban, Rivaroxaban and Edoxaban monitoring in Adults in Primary Care please Click Here

MHRA Drug Safety Update - Direct-acting oral anticoagulants (DOACs): paediatric formulations; reminder of dose adjustments in patients with renal impairment Click Here

For NICE Guideline NG196 Atrial Fibrillation: diagnosis and management April 2021
or for Guidance page Click Here

Direct Oral Anticoagulants (DOACs) are recommended as first line treatment over Vitamin K
antagonists (warfarin) for treatment in newly initiated patients with non-valvular atrial fibrillation (NVAF) as per NICE NG196

Apixaban is recommended as first line (preferred) DOAC in newly diagnosed patients with NVAF,
unless contraindicated, not tolerated or clinically inappropriate.

For K&M Anticoagulant position statement and risk mitigation principles Click Here. NHSE updated the Commissioning recommendations for national procurement for direct-acting oral anticoagulant(s) (DOACs) on the 6th of September 2024. This document will be reviewed ASAP, via the normal ICB governance process, to reflect the current NHSE recommendations. 

For Reversal Agents Click Here