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Savaysa
edoxaban
Black Box Warnings .
Reduced Efficacy in Non-valvular Afib Pts w/ CrCl >95 mL/min
incr. ischemic stroke risk in pts on edoxaban 60 mg/day compared to pts on warfarin; use another anticoagulant in these pts
Premature Tx Discontinuation
incr. ischemic event risk when D/C edoxaban for reasons other than pathological bleeding or completion of therapy course; if must D/C edoxaban, consider administering another anticoagulant
Epidural/Spinal Hematoma Risk
epidural/spinal hematoma risk after epidural/spinal anesthesia or spinal puncture in anticoagulated pts; hematoma may result in long-term or permanent paralysis; incr. risk if indwelling epidural catheter use, concomitant use of drugs affecting hemostasis incl. NSAIDs, platelet inhibitors, or other anticoagulants, traumatic or repeated epidural or spinal puncture hx, spinal deformity, or spinal surgery hx; monitor s/sx neurologic impairment, treat urgently if needed; consider benefit vs. risk before neuraxial intervention in anticoagulated pts or planned anticoagulation for thromboprophylaxis
Adult Dosing .
Dosage forms: TAB: 15 mg, 30 mg, 60 mg
thromboembolism/stroke prevention
- [60 mg PO qd]
- Info: for non-valvular atrial fibrillation w/o moderate-severe mitral stenosis or mechanical heart valve; to convert from UFH infusion, start edoxaban 4h after UFH D/C; to convert from warfarin, D/C warfarin, then start edoxaban when INR <2.5; to convert from other anticoagulants, D/C anticoagulant, then start edoxaban at next scheduled dose; depending on bleeding risk, consider holding tx 1-2 days before surgery or invasive procedure; resume tx >24h postop
DVT/PE tx
- [<60 kg]
- Dose: 30 mg PO qd; Start: after 5-10 days of parenteral anticoagulant tx; Info: to convert from UFH infusion, start edoxaban 4h after UFH D/C; to convert from warfarin, D/C warfarin, then start edoxaban when INR <2.5; to convert from other anticoagulants, D/C anticoagulant, then start edoxaban at next scheduled dose; depending on bleeding risk, consider holding tx 1-2 days before surgery or invasive procedure; resume tx >24h postop
- [>60 kg]
- Dose: 60 mg PO qd; Start: after 5-10 days of parenteral anticoagulant tx; Info: to convert from UFH infusion, start edoxaban 4h after UFH D/C; to convert from warfarin, D/C warfarin, then start edoxaban when INR <2.5; to convert from other anticoagulants, D/C anticoagulant, then start edoxaban at next scheduled dose; depending on bleeding risk, consider holding tx 1-2 days before surgery or invasive procedure; resume tx >24h postop
renal dosing
- [thromboembolism/stroke prophylaxis]
- CrCl >95: avoid use; CrCl 51-95: 60 mg qd; CrCl 15-50: 30 mg qd; CrCl <15: avoid use
- HD/PD: avoid use
- [DVT/PE tx]
- CrCl 15-50: 30 mg qd; CrCl <15: avoid use
- HD/PD: avoid use
hepatic dosing
- [see below]
- Child-Pugh Class B or C: avoid use
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.