Management of bleeding in patients on direct oral anticoagulants in Sri Lanka

Direct oral anticoagulants (DOACs) are being used increasingly in Sri Lanka. However, the specific antidotes for the reversal of DOACs are not currently available in Sri Lanka. Although DOACs have a predictable dose response they may cause bleeding, including major bleeds such as intra cranial and gastrointestinal bleeds. Most of the available algorithms providing guidance for management of bleeding in patients on DOACs contain laboratory tests and therapeutic agents that are not available in Sri Lanka. Therefore, it is timely to have an evidence-based guide for managing patients who develop bleeding while on a DOAC in Sri Lanka.