Preventive Strategies against Bleeding due to Nonvitamin K Antagonist Oral Anticoagulants
Table 2
Indication and dose regimens of Dabigatran etexilate, Rivaroxaban, and Apixaban [2–18].
Dabigatran etexilate
Rivaroxaban
Apixaban
VTE Prophylaxis
220 mg/day (2 capsules of 110 mg OD) or 150 mg/day (2 capsules of 75 mg OD) →if CrCl 30–50 mL/min, if >75 ys, if verapamil, amiodarone and quinidine THR: 28–35 days TKR: 10 days
5 mg/day (1 tablet of 2.5 mg BID) THR: 32–38 days TKR: 10 days
Nonvalvular atrial fibrillation
300 mg/day (1 capsule of 150 mg BID) 220 mg/day (EU) (1 capsule of 110 mg BID) →if >80 ys or verapamil 150 mg/day (US) (1 capsule of 75 mg BID) →if CrCl between 15–30 mL/min
20 mg/day (1 tablet of 20 mg OD) 15 mg/day (1 tablet of 15 mg OD) →if CrCl between 15–49 mL/min
10 mg/day (1 tablet of 5 mg BID) 5 mg/day (1 tablet of 2.5 mg BID) →if at least 2 of the following conditions: ≥80 ys, ≤60 kg or serum creatinine ≥1.5 mg/dL; or if CrCl 15–29 mL/min
VTE treatment
Adopted indication by the CHMP on 25th April 2014 (EU) 300 mg/day (US) (1 capsule of 150 mg BID) after 5–10 days of parenteral anticoagulation
Treatment phase: 30 mg/day (1 tablet of 15 mg BID) for 21 days Secondary prevention: 20 mg/day (1 tablet of 20 mg OD) 15 mg/day (1 tablet of 15 mg OD) →if CrCl between 15-49 mL/min and the risk of bleeding outweighs the risk of recurrent DVT or PE
×
Prevention of atherothrombotic events after ACS with elevated cardiac biomarkers
×
5 mg/day (1 tablet of 2.5 mg BID) in association with ASA (75–100 mg) alone or ASA + clopidogrel (75 mg)
×
Off-label; BID: twice daily; CrCl: creatinine clearance; DVT: Deep-vein thrombosis; OD: once daily; PE: pulmonary embolism; THR: total hip replacement; and TKR: total knee replacement; vte: venous thromboembolism; CHMP: committee for medecinal products for human use.
