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Dabigatran renal dosing — GPhC CRA MCQ

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HardCardiovascular TherapeuticsDabigatran renal dosingGPhC CRA

A 78-year-old with atrial fibrillation is prescribed dabigatran 150 mg twice daily. Cockcroft–Gault creatinine clearance is 28 mL/min. What should the pharmacist do?

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Correct answer: A — Contact the prescriber; dabigatran is contraindicated

Dabigatran is contraindicated for this indication when creatinine clearance is below 30 mL/min because renal elimination is substantial and exposure rises sharply. The pharmacist must contact the prescriber for an alternative anticoagulation plan. A lower dabigatran dose does not remove the contraindication at 28 mL/min.

Reference: https://bnf.nice.org.uk/drugs/dabigatran-etexilate/