Introduction:The availability of non-vitamin K antagonist oral anti-coagulants alongside vitamin K antagonists has offered a variety of options for anti-coagulation, but has also necessitated a good understanding of the pharmacological properties of each of these drugs prior to their use, to maximise the therapeutic benefit and minimise patient harm Areas covered: This review article outlines the pharmacokinetic and pharmacodynamic profiles of the currently licensed NOACs and VKAs that are most commonly used in clinical practice, with the aim of demonstrating how variations in these processes contribute to their use in clinical practice. A literature search was conducted on PubMed using keywords and relevant articles published by the 31 st of December 2018 were included.
Expert opinion:The effect of a drug is determined by a combination of elements which include patient characteristics and external influences, in addition to its pharmacokinetic and pharmacodynamic properties. A good understanding of this is essential. Despite the wealth of information available, particularly on VKAs, our knowledge on the pharmacology responsible for certain drug effects and inter-individual variations is still limited. Increasing efforts are being made to uncover these and includes focus on pharmacogenomics and drug transporter proteins.