Mechanism of Action

• Direct Xa inhibition

Half-Life

• 10-14 hours

Metabolism

• 35% Renal, Biliary ~ 25% removed by HD

Dosing – Adult

• NVAF: 60 mg once daily
• VTE: 60 mg daily after 5-10 days of initial therapy with parenteral anticoagulant
• ≤60 kg or concomitant therapy with specific P-glycoprotein inhibitors: 30 mg daily 

Dosing – Pediatric

• Safety and efficacy in pediatric patients not established

Monitoring

• Not required, can use: chromogenic anti-factor Xa or mass spectrometry

*The International Society on Thrombosis and Haemostasis (ISTH) 2016 guidelines suggest avoiding NOACs in patients with BMI >40 kg/m2 or weight >120 kg due to lack of clinical data