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Rivaroxaban renal dosing in AF — GPhC CRA MCQ

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HardRenal and Hepatic ImpairmentRivaroxaban renal dosing in AFGPhC CRA

A 71-year-old woman with AF is prescribed rivaroxaban 20mg once daily. Her creatinine clearance is 42mL/min, weight 61kg and liver function is normal. She has no bleeding symptoms. What is the most appropriate action?

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Correct answer: B — Query whether the AF dose should be reduced for her renal function.

Rivaroxaban dosing for non-valvular AF depends on renal function, and dose reduction is used at lower creatinine clearance thresholds. A creatinine clearance of 42mL/min should prompt checking the dose against BNF guidance and querying if needed. Aspirin is not an equivalent anticoagulant substitute for AF stroke prevention.

Reference: BNF