The use of novel oral anticoagulation (NOACs) has emerged as an alternative for oral anticoagulation with vitamin-K antagonists in different clinical settings. However, despite the several advantages of these new drugs, there are also several limitations and cautious is recommended in different clinical settings in patients with a high comorbidity index. This review article will describe the current evidence of treatment monitoring, possible drug interaction, and will give an overview about treatment options in case of complications.