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Cirrhosis sedative request — GPhC CRA MCQ

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HardRenal and Hepatic ImpairmentCirrhosis sedative requestGPhC CRA

Which patient factor is a licensed contraindication to rivaroxaban rather than a circumstance requiring dose selection or closer review?

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Correct answer: E — Child–Pugh B cirrhosis with coagulopathy and clinically relevant bleeding risk

Rivaroxaban is contraindicated in hepatic disease associated with coagulopathy and clinically relevant bleeding risk, including cirrhotic patients with Child–Pugh B or C disease. The other features may affect risk assessment, indication-specific dosing or monitoring, but none is by itself the stated hepatic contraindication. Age and low body weight do not form the apixaban-style dose-reduction rule for rivaroxaban.

Reference: Xarelto 20 mg film-coated tablets SmPC: https://www.medicines.org.uk/emc/product/2793/smpc