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DOAC renal contraindication — GPhC CRA MCQ

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HardRenal and Hepatic ImpairmentDOAC renal contraindicationGPhC CRA

An 83-year-old woman with atrial fibrillation has an eGFR of 12 mL/min/1.73m2. A discharge prescription includes rivaroxaban 20mg once daily and the family asks to collect it immediately. What is the most appropriate action?

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Correct answer: C — Withhold supply and urgently contact the prescriber

Severe renal impairment can make rivaroxaban inappropriate or require specialist decision-making depending on indication. The listed dose is unlikely to be suitable at eGFR 12 mL/min/1.73m2. The pharmacist should urgently clarify before supply. INR monitoring does not make rivaroxaban safe in this context.

Reference: BNF