DOAC renal review — GPhC CRA MCQ

Correct answer: D — Calculate Cockcroft–Gault clearance for an urgent dose review

Dabigatran is substantially renally cleared, and bleeding with deteriorating renal function needs urgent assessment. MHRA advises using Cockcroft–Gault creatinine clearance, not laboratory eGFR, for DOAC dose decisions; age, weight, indication, interacting medicines and bleeding severity must also be reviewed.

Reference: MHRA: using creatinine clearance for medicines requiring renal dose adjustment: https://www.gov.uk/drug-safety-update/prescribing-medicines-in-renal-impairment-using-the-appropriate-estimate-of-renal-function-to-avoid-the-risk-of-adverse-drug-reactions