The non-vitamin K oral anticoagulants (NOACs) are set to replace vitamin K antagonists
(principally warfarin), unfractionated heparin and low molecular weight heparin as the leading antithrombotic
prophylaxis in several medical and surgical settings. As a group, NOACs have a better
safety profile and at least an equivalent (and sometimes superior) efficacy profile than their comparator.
The objective of this review is to provide the practitioner with a comprehensive, balanced and contemporary
view of these drugs and their applications. More specifically, it focuses on the evidence
base for their licences, use in clinical practice (such as in renal dysfunction, orthopaedic surgery, atrial
fibrillation, and venous thromboembolism, and the effects of co-medications), responses to actual or perceived haemorrhage,
and the role of the laboratory.