Anticoagulant drugs are used to prevent and treat thrombotic disorders in millions of patients worldwide. This Milestone plots the history of anticoagulant drugs on an interactive Timeline, starting with the discovery and clinical trials of heparin and warfarin. The synthesis of low-molecular-weight heparins enabled more convenient, outpatient treatment of thrombosis. Since 2000, the development of direct oral factor Xa and thrombin inhibitors as well as antidotes to reverse the effects of these drugs has revolutionized the practice of anticoagulation. Nevertheless, the delicate cost–benefit balance between bleeding and prevention of clotting continues to drive research into novel agents and optimal dosing regimens.

Produced with support from:

This Milestone is editorially independent, produced with financial support from a third party. About this content.

Editorial credits

Editorial Lead: Gregory B. Lim
Milestones: Conor A. Bradley, Megan Cully, Irene Fernández-Ruiz, Karina Huynh, Gregory B. Lim, Shimona Starling
Production Editor: Simon Fenwick
Art Editor: Chris Ryan
Multimedia Producer & Narrator: Ed Prosser
Animator, The history of warfarinDog and Rabbit, in association with Jules Bartl
Animator, Drug targets in the coagulation cascade: Andrew Khosravani
Multimedia Adviser: Shamini Bundell
Publishing Manager: Rebecca Ratty
Web Production Manager: Dipti Shah
Marketing: Nicole Jackson
Sponsorship: Stephen Brown, Judy Yeh

We gratefully acknowledge scientific advice from:
Jack Hirsh (McMaster University, Hamilton, ON, Canada)
Dominick Angiolillo (College of Medicine – Jacksonville, University of Florida, FL, USA)

Contributing journals:
Nature Reviews Cardiology
Nature Reviews Clinical Oncology
Nature Reviews Drug Discovery
Nature Reviews Disease Primers
Nature Reviews Gastroenterology & Hepatology
Nature Reviews Rheumatology
Nature Medicine
Nature Communications
Scientific Reports