For the last 60 years, heparin and vitamin K antagonists have been the 
cornerstone of anticoagulation. Nowadays, the new anticoagulants, such as 
dabigatran, rivaroxaban and apixaban, show potential advantages over classical 
treatments. These agents inhibit specific coagulation factors and are 
administered orally at fixed doses. Furthermore, heparin and vitamin K 
antagonists have a fast onset of action, short-duration and predictable 
therapeutic effects. No interactions with foods have been described, although 
some drug-drug interactions have been reported. At the moment, no antidotes are 
available. However, due to the short half-life of these agents, antidotes are 
less essential. The new anticoagulants are at least as effective and safe as 
traditional treatments in the prevention of venous thromboembolism after 
orthopedic surgery, as well as in the prevention of stroke and systemic embolism 
in non-valvular atrial fibrillation. Dabigatran and rivaroxaban have also been 
shown to be effective in the treatment of acute venous thromboembolism. Due to 
their properties, these drugs could gradually replace heparin and especially 
vitamin K antagonists. Hopefully, many of our patients will be able to 
discontinue classical anticoagulant treatment and others will never begin it.