DOACs/vitamin K antagonists induced hemorrhagic adverse effects; How to bridge therapy before procedures

Direct oral anticoagulants (DOACs) are emerging as attractive alternatives to vitamin K antagonist which have long been the standard of care in anticoagulation. DOACs are indicated for both prevention and treatment. DOACs have emerged as more effective, safe, and convenient treatment options in thromboembolic settings. With the availability of a gamut of DOACs, clinicians are faced with challenging decisions relating to its hemorrhagic adverse effects. This review will provide an overview on how to manage the hemorrhagic adverse effects of DOACs/vitamin K antagonists and act as a practical guide for clinicians to optimize DOAC use in such challenging scenarios. Topics addressed include transitioning between anticoagulant regimens known as the bridge therapy.