Mechanism of Action

• Direct Xa inhibition

Half-Life

• 5-9 hours

Metabolism

• 33% Renal, Biliary
• Not removed by HD

Dosing – Adult

• NVAF (Nonvalvular Atrial Fibrillation), stroke prevention:
  • -CrCl >50 ml/min: 20 mg once daily
  • -CrCl 15-50 ml/min: 15 mg once daily
  • -CrCl<15: avoid use
• VTE treatment:
  • CrCl >30: 15 mg Q 12 hrs x 21 days, followed by 20 mg daily, taken with food
  • CrCl<30: avoid use 

Dosing – Pediatric

• Please refer to pediatric section for information on use in children

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