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Edoxaban renal dose — GPhC CRA MCQ

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HardCardiovascular TherapeuticsEdoxaban renal doseGPhC CRA

A discharge prescription is received for edoxaban 60 mg once daily for AF. The patient is 78 years old and their calculated creatinine clearance is 38 mL/min. Their weight is 72 kg and they are not taking ciclosporin, dronedarone, erythromycin or ketoconazole. What is the most appropriate action?

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Correct answer: D — Query the dose and suggest 30 mg once daily if edoxaban is continued

Edoxaban dose reduction is required in AF when creatinine clearance is 15 to 50 mL/minute. This patient’s creatinine clearance is 38 mL/minute, so 60 mg once daily should be queried. The pharmacist should contact the prescriber rather than advising ad hoc tablet splitting. Aspirin would increase bleeding risk and is not a dose adjustment strategy.

Reference: BNF