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DOAC in severe renal impairment — GPhC CRA MCQ

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HardRenal and Hepatic ImpairmentDOAC in severe renal impairmentGPhC CRA

A patient with creatinine clearance 12 mL/min is prescribed dabigatran for AF after discharge. The community pharmacist notices the renal result in the letter. What is the most appropriate action?

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

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Correct answer: E — Do not supply until the anticoagulant choice is urgently clarified

Dabigatran is substantially renally cleared and is contraindicated or unsuitable in severe renal impairment depending on indication and threshold. A creatinine clearance of 12 mL/min requires urgent clarification before supply. The pharmacist should not substitute antithrombotic therapy independently. Dabigatran capsules should not be opened because bioavailability may increase.

Reference: BNF