Table 5.

Dosing in non-valvular atrial fibrillation: renal function, age and body weight

DabigatranRivaroxabanApixabanEdoxaban
Standard dose150 mg bd20 mg bd5 mg bd60 mg od
Renal function
CrCl 30–49 mL/minConsider 110 mg bd15 mg od5 mg bd30 mg od
CrCl 15–29 mL/minNot recommendedUse with caution2.5 mg bd30 mg od
CrCl <15 mL/minNot recommendedNot recommendedNot recommendedNot recommended
CrCl >95 mL/min–––Not recommended
Age≥80 years: 110 mg bd
≥75 years: consider 110 mg bd		–2.5 mg bd where two of:

  • serum creatinine ≥1.5 mg/dL

  • age ≥80 years

  • weight ≤60 kg

–
Body weight––2.5 mg bd where two of:

  • serum creatinine ≥1.5 mg/dL

  • age ≥80 years

  • weight ≤60 kg

30 mg od:

  • weight ≤60 kg

Others100 mg bd:

  • concomitant verapamil> consider where increased risk of bleeding

30 mg od:

  • concomitant use of cyclosporine, dronedarone, erythromycin or ketoconazole

  • bd = twice per day; CrCl = creatinine clearance; NVAF = non-valvular atrial fibrillation; od = once daily