Oral anticoagulants treat or prevent blood clotting. They can be vitamin K antagonists like warfarin, direct thrombin inhibitors or DTIs, such as dabigatran and factor Xa inhibitors, such as rivaroxaban.

Warfarin works by inhibiting the enzyme VKORC1, which helps produce clotting factors. This slows down blood coagulation and prevents abnormal clot formation.

However, warfarin can cause uncontrolled bleeding and interact with other medications to interfere with hemostasis. So, it requires close monitoring.

Warfarin action can be reversed by administering vitamin K1, frozen plasma, or prothrombin complex concentrates.

DTIs can be effective warfarin alternatives in reducing the risk of stroke and systemic embolism. Anti-Xa drugs and DTIs directly block the activity of factor Xa or thrombin, which are key components in the coagulation cascade.

These have more predictable pharmacokinetics, do not require frequent monitoring, and have fewer drug interactions than warfarin.