Practice guide to dosing of direct acting oral anticoagulants in patients with renal impairment

· Medicines Use & Safety

Choosing the correct dose of an anticoagulant is important to ensure that the patient receives the benefits in reduction of thrombo-embolic events whilst minimising the risk of adverse bleeding events.

For many patients the  direct acting oral anticoagulants (DOACs) are now offering a suitable alternative to treatment with a vitamin K antagonist (usually warfarin). This paper, focussing on use of DOACs in patients with atrial fibrillation, discusses the debate regarding the dosing of DOACs in patients with renal impairment and offers some practical advice on selecting the dose in the clinical setting.


Acute CareApixabanDabigatran etexilateEdoxabanNewsPrimary CareRenal and urologic disordersRivaroxabanTransfer of care