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Direct oral anticoagulant bleeding in renal impairment — GPhC CRA MCQ

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HardRenal and Hepatic ImpairmentDirect oral anticoagulant bleeding in renal impairmentGPhC CRA

A patient taking apixaban with stage 4 chronic kidney disease reports black stools and dizziness. He asks whether to buy iron tablets. What monitoring is required?

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Correct answer: E — Advise immediate urgent medical assessment for possible gastrointestinal bleeding

Black stools and dizziness in a patient taking an anticoagulant suggest possible gastrointestinal bleeding. Advanced renal impairment can increase bleeding risk with some anticoagulants. This requires urgent medical assessment rather than over-the-counter iron. Anticoagulant interruption decisions should be clinician-led.

Reference: BNF; NICE CKS