NOAC

Posted On February 22, 2020

Use of NOAC in atrial fibrillation

FXa Inbibitor

Eliquis (Apixaban)

• minimal interaction with cytochrome, 25% excreted renal
• Usual dose: 5 mg bid
• Use the lower dose of 2.5 mg bid, if 2 of following:
  • over age 80
  • Creat over 1.5
  • weight <60 kg
• End stage renal disease:
  • 5 mg bid

Xarelto (Rivoxaban)

• Usual: Dose 20 mg qd w evening meal
• Avoid use if CrCl <15
• Notes: do not use Dilantin, Tegretol, antifungal, do not use in liver disease, more interaction with cytochrome

Direct Thrombin inhibitor = DTI

Pradaxa (Dabibatran)

• Dose 150 mg bid
• dose: 110 mg bid: if age over 75, or high risk of bleeding
• 75 mg bid: if CCr 15-50
• no interaction with cytochrome
• side effect: Dyspepsia 11%
• medication breaks down with moisture

CHA2DS2-VASc Score for Atrial Fibrillation Stroke Risk

Has-bled score for bleeding risk

Neurology Residents – Very nice table