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Apixaban missed dose — GPhC CRA MCQ

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EasyCardiovascular TherapeuticsApixaban missed doseGPhC CRA

A 76-year-old man with non-valvular atrial fibrillation is prescribed apixaban 5mg twice daily. He asks what to do because he forgot this morning's tablet and his next dose is due at 22:00. It is currently 14:00. What is the most appropriate action?

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

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Correct answer: CTake the missed dose now and take the next dose at the usual time

For twice-daily apixaban, a missed dose can be taken as soon as remembered and the twice-daily schedule continued. Doubling the next dose increases bleeding risk and aspirin is not an appropriate substitute. The advice should also include checking the patient understands bleeding precautions and when to seek help.

Reference: BNF; NHS medicines guidance