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DOAC dose review in renal impairment — GPhC CRA MCQ

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HardCardiovascular TherapeuticsDOAC dose review in renal impairmentGPhC CRA

A patient prescribed dabigatran asks to open the capsules and mix the pellets with yoghurt because swallowing is difficult. What should the pharmacist advise?

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Correct answer: E — Keep capsules intact; opening raises exposure by about 75%

Dabigatran capsules must be swallowed whole. Removing the capsule shell can increase bioavailability by about 75% and raise bleeding risk. Swallowing difficulty therefore requires prescriber review of formulation or anticoagulant choice rather than manipulating the capsule.

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