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Apixaban renal dosing — GPhC CRA MCQ

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EasyRenal and Hepatic ImpairmentApixaban renal dosingGPhC CRA

An 84-year-old weighing 58 kg presents a prescription for apixaban 5 mg twice daily for atrial fibrillation. Her serum creatinine is 150 micromol/L. She is starting therapy today. What is the most appropriate action?

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Correct answer: D — Query whether a reduced apixaban dose is required

Apixaban dose reduction in atrial fibrillation is required when specific criteria are met, including combinations of age, weight and serum creatinine. This patient appears to meet criteria that may require a reduced dose, so the pharmacist should query the prescription. Aspirin is not an equivalent substitute for stroke prevention in atrial fibrillation. Taking both daily doses together is inappropriate.

Reference: https://www.pharmacyregulation.org/students-and-trainees/pharmacist-education-and-training/registration-assessment