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Apixaban dose selection — GPhC CRA MCQ

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HardCardiovascular TherapeuticsApixaban dose selectionGPhC CRA

A prescription for apixaban 5 mg twice daily is received for stroke prevention in atrial fibrillation. The patient is 83 years old, weighs 58 kg, and has a serum creatinine of 145 micromol/L. What is the most appropriate action?

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Correct answer: B — Query the dose because 2.5 mg twice daily is likely indicated

For non-valvular atrial fibrillation, apixaban dose reduction is used when at least two specified criteria are met: advanced age, low body weight, and raised serum creatinine. This patient meets all three criteria, so 2.5 mg twice daily is likely appropriate. INR testing is not used to monitor apixaban effect in routine practice. The pharmacist should query rather than independently alter the prescription unless acting within an appropriate prescribing role.

Reference: BNF