Treatment Table 3. Drugs
Drug (Brand)
Dabigatran (Pradaxa®
Route
Direct thrombin inhibitor ) PO
Dose ClCr
150 mg bid ClCr
75 mg bid
> 30 mL/min: 15-30 mL/min:
Side Effects/ Warnings
Hemorrhage, dyspepsia. Consider dose reduction for patients with moderate renal insufficiency taking dronedarone or systemic ketoconazole. Use with caution in conjunction with verapamil, amiodarone, quinidine, clarithromycin, ciclosporin, itraconazole and tacrolimus.
Factor Xa inhibitor
Rivaroxaban (Xarelto®
)
PO with the evening meal
ClCr
20 mg once daily ClCr
15 mg once daily
> 50 mL/min: 15-50 mL/min:
Hemorrhage, nausea, vomiting, diarrhea. The use of rivaroxaban in patients receiving azole antimycotics and HIV protease inhibitors is currently NOT recommended. Use with caution in conjunction with macrolide antibiotics, rifampicin, phenytoin, carbamazepine, phenobarbital, or St. John's wort.
FDA-approved to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (approved aſter submission of the guidelines)
Comments
FDA-approved to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation
