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Rivaroxaban renal impairment — GPhC CRA MCQ

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ModerateRenal and Hepatic ImpairmentRivaroxaban renal impairmentGPhC CRA

A patient with AF takes rivaroxaban 20 mg once daily. A recent hospital letter gives creatinine clearance 42 mL/min. The GP repeat still lists 20 mg. What is the most appropriate action?

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Correct answer: A — Query whether renal dose adjustment is required

Rivaroxaban dosing for AF depends on renal function, and dose reduction is needed at specified creatinine clearance thresholds. The pharmacist should query the discrepancy and ensure creatinine clearance, not just eGFR, has been considered where required. Aspirin is not an appropriate substitute for AF anticoagulation. Stopping anticoagulation without review increases stroke risk.

Reference: BNF