Edoxaban in NVAF

Question 1

Edoxaban PK

Answer 1

BA = 62%, Anticoagulation onset = 1-2 hr, half-life = 9-10 hr

Question 2

Edoxaban NVAF Dose

Answer 2

60 mg once daily

Question 3

Edoxaban NVAF Dose Adjustment

Answer 3

30 mg once daily - CrCl 15–50 mL/min/1.73 m2

Question 4

Edoxaban Avoid Use NVAF

Answer 4

• CrCl > 95 mL/min/1.73 m2
• CrCl < 15 mL/min/1.73 m2, Dialysis
• Rifampin
• Chemotherapy agents

Question 5

Converting from Edoxaban Oral to Warfarin

Answer 5

For patients taking 60 mg of edoxaban, reduce the dose to 30 mg and begin warfarin concomitantly. For patients receiving 30 mg of edoxaban, reduce the dose to 15 mg and begin warfarin concomitantly. The INR must be measured at least weekly and just before the daily dose of edoxaban to minimize the influence of edoxaban on INR measurements. Once a stable INR ≥ 2.0 is achieved, edoxaban should be discontinued and warfarin continued

Question 6

Converting from Parenteral Edoxaban to Warfarin

Answer 6

Discontinue edoxaban, and administer a parenteral anticoagulant and warfarin at the time of the next scheduled edoxaban dose. Once a stable INR ≥ 2.0 is achieved, the parenteral anticoagulant should be discontinued and warfarin continued

Question 7

Converting from Edoxaban to Anticoagulants (with rapid onset) Other than Warfarin

Answer 7

Discontinue edoxaban, and begin the new anticoagulant (oral or parenteral; other than warfarin) at the usual time of the next dose of edoxaban

Question 8

Converting from Warfarin to Edoxaban

Answer 8

Discontinue warfarin and start edoxaban when the INR is ≤ 2.5

Question 9

Converting from Anticoagulants (with rapid onset) Other than Warfarin to Edoxaban

Answer 9

Discontinue the other oral anticoagulant (other than warfarin) or LMWH, and begin taking edoxaban at the usual time of the next dose of the other anticoagulant. For UFH administered by continuous infusion, stop the infusion and start edoxaban 4 hr later