text: Warfarin treatment requires blood monitoring and dose adjustments regularly due to its narrow therapeutic window. If supervision isnt adequate warfarin poses a threat in causing, all too frequent, haemorrhagic events and multiple interactions with food and other drugs. Currently, the main problem with low molecular weight heparin (LMWH) is the administration route, as it has to be given subcutaneously. Because of these disadvantages there has been an urgent need for better anticoagulant drugs. For a modern society, convenient and fast drug administration is the key to a good drug compliance. In 2008 the first direct Xa inhibitor was approved for clinical use. Direct Xa inhibitors are just as efficacious as LMWH and warfarin but they are given orally and dont need as strict monitoring. Other Xa inhibitors advantages are rapid onset/offset, few drug interactions and predictable pharmacokinetics. The rapid onset/offset effect greatly reduces the need for “bridging” with parenteral anticoagulants after surgeries. Today there are four factor Xa inhibitors marketed: rivaroxaban, apixaban, edoxaban and betrixaban.