9
Table 3. Dosing Regimens for Prophylaxis/Treatment of
VTE in Patients with Cancer
Clinical Setting Drug Regimen
a
Initial (cont'd)
Enoxaparin
j,l,m,n
1 mg/kg q12h
1.5 mg/kg qd
Tinzaparin
j,l,m,o
175 U/kg qd
Fondaparinux
j,l,p
<50 kg : 5.0 mg qd
50–100 kg : 7.5 mg qd
>100 kg : 10 mg qd
Rivaroxaban 15 mg orally q12h for 21 days
Long-term
p,q,r
Dalteparin
l,m,s
200 U/kg qd for 1 month, then
150 U/kg qd
Enoxaparin
l,m,n
1.5 mg/kg qd
1 mg/kg q12h
Tinzaparin
m,o
175 U/kg qd
Warfarin Adjust dose to maintain INR 2–3
Rivaroxaban
m,t
15 mg orally q12h for 21 days, followed by:
20 mg qd thereaer (both doses with food)
Edoxaban
m,t
Needs ≥5 days of parenteral anticoagulation
prior to its start, then switch to:
60 mg orally qd or 30 mg orally qd in
those weighing ≤60 kg, have creatinine
clearance between 30–50 mL/min or need
concomitant use of a P-gp inhibitor
(cont'd)
