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Oral anticoagulant missed dose — GPhC CRA MCQ

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ModeratePatient Counselling and Pharmaceutical CareOral anticoagulant missed doseGPhC CRA

A patient taking apixaban twice daily for atrial fibrillation missed this morning's dose and remembers at 4 pm. The evening dose is due at 8 pm. What is the most appropriate action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Advise according to apixaban missed-dose guidance and avoid taking two doses together without checking

Missed-dose advice for DOACs depends on the product and timing. Patients should follow product-specific guidance and should not double doses without advice. The pharmacist should give clear instructions based on the patient leaflet or local anticoagulation guidance. Adherence support is important because missed anticoagulant doses can increase stroke risk.

Reference: BNF; manufacturer guidance