Abstract
Novel oral anticoagulants (NOAC), have appeared or are under development to overcome the limitation of warfarin, which has been widely used for more than 50 years in Japan. When compared to warfarin, NOAC are as effective or superior in the prevention of stroke, as same or lower in the frequency of major hemorrhagic complication, and much lower in the frequency of intracranial bleedings. Therefore, NOAC is superior to warfarin. However, several issues have been pointed out, such as, how to manage major hemorrhage, rt-PA thrombolysis in patients treated with NOAC, proper administration, and management around operation period. In this review, these several issues are discussed from the stand point of pharmacological properties of NOAC and previous reports.
