Edoxaban has most recently joined the rest. It was soon followed by Factor Xa inhibitors-rivaroxaban and apixaban. In 2010, dabigatran, a direct thrombin inhibitor, became the first target specific anticoagulant approved by FDA. These drawbacks and limitations fuelled the development of newer agents. There were various limitations like its narrow therapeutic index, food and drug interactions, need for regular monitoring and frequent dose adjustments. Then, in the absence of a previous history of venous thromboembolism or a known predisposing condition, it is safe to abruptly discontinue anticoagulation in most patients.Warfarin, a vitamin K antagonist (VKA), was the only oral anticoagulant for more than half a century. After stopping heparin, oral anticoagulation with warfarin should be continued for six weeks. During this time warfarin is generally begun, and it is important to continue the patient on warfarin for five to seven days while the patient is receiving intravenous heparin therapy. Heparin is generally continued for seven to ten days. Although monitoring the PTT may not prevent hemorrhage, it will help prevent further thrombosis. However, once venous thrombosis has already occurred, it is necessary to use full-dose heparin, preferably by the continuous intravenous route, with maintenance of the partial thromboplastin time (PTT) at 1 1/2 times the control at all times. It has been shown that in many cases, low-dose heparin is effective in the prevention of both venous thrombosis and pulmonary embolism. Recently, a number of studies have been published which are of considerable help in the management of these disorders. The physician frequently encounters the problems of deep vein thrombosis and pulmonary embolism.

Antidote for heparin and warfarin