For DOACs, which monitoring parameter is essential?

• A. Regular imaging studies.
• B. Platelet count monitoring.
• C. Renal function and signs of bleeding.
• D. Liver enzymes monitoring.

Answer: (C)

When using DOACs, the essential monitoring centers on renal function and signs of bleeding. These drugs are anticoagulants cleared to varying degrees by the kidneys, so assessing kidney function before starting therapy and periodically during treatment helps prevent drug accumulation and overdose, with dose adjustments or avoidance in significant renal impairment. In parallel, watching for bleeding symptoms—such as unusual bruising, gum or nosebleeds, blood in stool or urine, or signs of internal bleeding—is vital because their main risk is increased bleeding. Routine imaging, platelet counts, or liver enzyme monitoring are not required for all patients on DOACs, since these drugs do not routinely affect platelets and do not demand regular hepatic or imaging surveillance unless there are specific clinical concerns.