Dosing Considerations

Dosing
Renal Function Dabigatran Edoxaban# Rivaroxaban Apixaban
Normal or Mild Impairment
  • 150mg BID (CrCL >30mL/min)
  • 60mg daily (CrCL 50 to ≤95mL/min)
  • 30mg daily CrCL >30 to <50mL/min)
  • 20mg daily with evening meal (CrCL >50mL/min)
  • 5mg BID*
Moderate impairment
  • 150mg BID (CrCL >30mL/min)
  • 30 mg daily (CrCL 30- 50mL/min)
  • 15mg daily with evening meal (CrCL 30-50mL/min)
  • 5mg BID*
Severe impairment CrCL: 15-30mL/min
  • 75 mg BID
  • 30 mg daily (CrCL 15-50mL/min)
  • 15mg daily with evening meal
  • 5mg BID*
End-stage CKD not on dialysis CrCL < 15mL/min
  • Not studied
  • Not recommended
  • Not recommended
  • Not studied
End-stage CKD on hemodialysis
  • Not studied
  • No recommendation
  • Not recommended
  • 5mg BID*

#Do not use in patients with CrCL >95mL/min due to reduced efficacy.

*Use apixaban 2.5mg BID if any 2 patient characteristics present: Cr > 1.5mg/dL, > 80 yo, body weight < 60kg.