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September 2016

Appropriate Apixaban Dosing: Prescribers Take Note

Author Affiliations
  • 1Department of Medicine, McMaster University, Hamilton, Ontario, Canada
  • 2Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
  • 3Thrombosis and Atherosclerosis Research Institute, Hamilton General Hospital, Hamilton, Ontario, Canada
JAMA Cardiol. 2016;1(6):635-636. doi:10.1001/jamacardio.2016.1841

The direct oral anticoagulants, which include apixaban, rivaroxaban, edoxaban tosylate, and dabigatran etexilate mesylate, are increasingly being used in place of warfarin for stroke prevention in patients with nonvalvular atrial fibrillation (AF). In randomized clinical trials that included more than 71 000 patients,1 these agents were at least as effective as warfarin but were associated with less serious bleeding, particularly less intracranial hemorrhage. With the convenience of fixed dosing and their proven efficacy and safety, guidelines now recommend the direct oral anticoagulants over warfarin for stroke prevention in most patients with AF.2-4 However, to be effective, the direct oral anticoagulants must be given at the appropriate doses (Table).

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