Table 1 DOAC - Approved Indications and Dosing

Prevention of VTE in patients undergoing elective HRS or KRS.

2.5 mg BID for 32-38d (HRS) or 10-14d (KRS)

10 mg OD for 5wk (HRS) or 2wk (KRS)

220 mg OD for 28-35d (HRS) or 10d (KRS);

Reduce to 150 mg OD if CrCl = 30-50 ml/min OR age ≥ 75 yr. OR concomitant amiodarone, quinidine or verapamil

Treatment of DVT and PE, and prevention of recurrent DVT and PE in adults.

10 mg BID for 1wk, then 5 mg BID for up to 6mo, then 2.5 mg BID for prevention

15 mg BID for 3wk, then 20 mg OD

150 mg BID

Prevention of atherothrombotic events after an ACS

NI

2.5 mg BID for up to 12mo

NI

 Full dose

5 mg BID

20 mg OD

150 mg BID

 Reduced dose

2.5 mg BID if CrCl< 30 ml/min, OR if 2 of 3:

Age > 80

Weight < 60

SCr > 135 (avoid if CrCl< 15)

15 mg OD if CrCl = 15–50

(avoid if CrCl< 15)

110 mg BID if age > 80 OR concomitant verapamil (avoid if CrCl< 30)