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Table 1 DOAC - Approved Indications and Dosing

From: Clinical pharmacist led hospital-wide direct oral anticoagulant stewardship program

  Apixaban (18) Rivaroxaban (17) Dabigatran (16)
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
Prevention of stroke and systemic embolism in patients with NVAF.
 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)
  1. ACS acute coronary syndromes, BID twice daily, CrCl creatinine clearance, DVT deep vein thrombosis, HRS hip replacement surgery, KRS knee replacement surgery, NI not indicated, NVAF non-valvular atrial fibrillation, OD once daily, PE pulmonary emboli, VTE venous thromboembolism