Laboratory Monitoring for Heparins, Fondaparinux, Direct Thrombin Inhibitors, and Oral Anti-Xa Medications

Laboratory testing modalities and recommendations for monitoring heparin, heparin-like medications, direct thrombin inhibitors (DTIs), and direct anti-Xa inhibitors (DXIs), including indications, testing recommendations, testing modalities, and test limitations are discussed. There are several options available for laboratory monitoring of these drugs, all with varying levels of utility. New DTI's and DXI's are in clinical trials and the number of patients undergoing direct oral anticoagulant therapy will continue to expand.