Doses, terminology, and indications for oral factor Xa and oral direct thrombin inhibitors
| Term . | Dose . | Indications . | Notes . |
|---|---|---|---|
| Initiation dose | Rivaroxaban 15 mg bid × 21 d | VTE | Start therapeutic dose after indicated duration |
| Apixaban 10 mg bid × 7 d | |||
| Therapeutic dose | Rivaroxaban 20 mg daily | 1. VTE 2. NVAF | For VTE, dose initiated after at least 5 d of parenteral anticoagulation§ |
| Edoxaban 60 mg daily§ | |||
| Dabigatran 150 mg bid§ | |||
| Apixaban 5 mg bid | |||
| Adjusted dose | Rivaroxaban 15 mg daily | NVAF | CrCl 15-50 mL/min |
| Edoxaban 30 mg daily | 1. VTE 2. NVAF | 1. CrCl 15-50 mL/min, weight ≤60 kg, certain concomitant P-gp inhibitors 2. CrCl 15-50 mL/min | |
| Apixaban 2.5 mg bid | NVAF | 2 of 3 criteria met: SCr, ≥1.5 mg/dL; age ≥80 y; weight, ≤60 kg | |
| Low dose | Apixaban 2.5 mg bid∗†‡ | VTE | 1. Primary prevention: VTE prevention in patients with cancer,∗ THA,† and TKA† 2. Secondary prevention: extended phase therapy for patients with VTE‡ |
| Rivaroxaban 10 mg daily∗†‡ | |||
| Dabigatran 110 mg 1-4 h after surgery, then 220 mg daily for 28-35 d† | |||
| Very low dose | Rivaroxaban 2.5 mg bid | 1. PAD + revascularization within 10 d 2. Stable CAD or PAD | With low dose aspirin |
| Term . | Dose . | Indications . | Notes . |
|---|---|---|---|
| Initiation dose | Rivaroxaban 15 mg bid × 21 d | VTE | Start therapeutic dose after indicated duration |
| Apixaban 10 mg bid × 7 d | |||
| Therapeutic dose | Rivaroxaban 20 mg daily | 1. VTE 2. NVAF | For VTE, dose initiated after at least 5 d of parenteral anticoagulation§ |
| Edoxaban 60 mg daily§ | |||
| Dabigatran 150 mg bid§ | |||
| Apixaban 5 mg bid | |||
| Adjusted dose | Rivaroxaban 15 mg daily | NVAF | CrCl 15-50 mL/min |
| Edoxaban 30 mg daily | 1. VTE 2. NVAF | 1. CrCl 15-50 mL/min, weight ≤60 kg, certain concomitant P-gp inhibitors 2. CrCl 15-50 mL/min | |
| Apixaban 2.5 mg bid | NVAF | 2 of 3 criteria met: SCr, ≥1.5 mg/dL; age ≥80 y; weight, ≤60 kg | |
| Low dose | Apixaban 2.5 mg bid∗†‡ | VTE | 1. Primary prevention: VTE prevention in patients with cancer,∗ THA,† and TKA† 2. Secondary prevention: extended phase therapy for patients with VTE‡ |
| Rivaroxaban 10 mg daily∗†‡ | |||
| Dabigatran 110 mg 1-4 h after surgery, then 220 mg daily for 28-35 d† | |||
| Very low dose | Rivaroxaban 2.5 mg bid | 1. PAD + revascularization within 10 d 2. Stable CAD or PAD | With low dose aspirin |
The symbols in the “Dose” column correspond to those in the “Notes” column.
bid, twice a day; CrCl, creatinine clearance; NVAF, nonvalvular atrial fibrillation; SCr, serum creatinine; THA, total hip arthroplasty; TKA, total knee arthroplasty.