Effect of direct thrombin antagonists and Xa inhibitors on clotting tests, and drug-specific assays
| Drug | PT | APTT | TT | Drug specific assay | |||
|---|---|---|---|---|---|---|---|
| Normal | Prolonged | Normal | Prolonged | Normal | prolonged | ||
| Dabigatran | Below or within therapeutic levels | Supra-therapeutic levels | Below or within therapeutic levels | Within or above therapeutic levels | Likely little or no drug present | Cannot interpret | Dilute thrombin time or ecarin clotting time |
| Rivaroxaban | Therapeutic levels unlikely but cannot be excluded | Therapeutic or supratherapeutic levels | Therapeutic or subtherapeutic levels | Therapeutic or supratherapeutic levels | Unaffected | Rivaroxaban-specific anti Xa activity | |
| Apixaban | Insensitive, cannot be assessed with these methods | Unaffected | Apixaban-specific anti Xa activity | ||||
| Edoxaban | Therapeutic levels cannot be excluded | Not useful | Unaffected | Edoxaban-specific anti Xa activity | |||
APTT = activated partial thromboplastin time; PT = prothrombin time; TT = thrombin time