How do direct oral anticoagulants (DOACs) function in the body?

Direct oral anticoagulants (DOACs) function by directly inhibiting specific clotting factors involved in the coagulation cascade. These medications target key proteins such as Factor Xa or thrombin (Factor IIa) to prevent the formation of blood clots. By inhibiting these clotting factors, DOACs effectively reduce thrombin generation, which is essential for the conversion of fibrinogen to fibrin, thereby impeding the clotting process.

This method of action distinguishes DOACs from other anticoagulants like vitamin K antagonists, which indirectly affect clot formation by inhibiting the synthesis of vitamin K-dependent clotting factors. The direct inhibition by DOACs allows for a more predictable anticoagulant effect and can lead to reduced monitoring requirements compared to traditional anticoagulants.