Approved US indications and dosing for NOACs
| Indication | Dabigatran17 | Rivaroxaban18 | Apixaban19 | Edoxaban21 |
|---|---|---|---|---|
| To reduce the risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation | For patients with CrCl >30 mL/min: 150 mg orally, twice daily For patients with CrCl 15–30 mL/min: 75 mg orally, twice daily | For patients with CrCl >50 mL/min: 20 mg orally, once daily with the evening meal For patients with CrCl 15–50 mL/min: 15 mg orally, once daily with evening meal | 5 mg orally twice daily In patients with at least 2 of the following characteristics: age ≥80 years, body weight ≤60 kg, or serum creatinine ≥1.5 mg/dL, the recommended dose is 2.5 mg orally twice daily | CrCl needs to be measured before initiating therapy. 60 mg once daily in patients with CrCl >50 to≤95 mL/min For patients with CrCl from 15 to 50 mL/min: 30 mg once daily Edoxaban should not be used in patients with creatinine clearance (CrCl) > 95 mL/min because of increased risk of ischaemic stroke compared with warfarin at the highest dose studied (60 mg) |
| For the treatment of deep venous thrombosis (DVT) and pulmonary embolism (PE) | For patients with CrCl >30 mL/min: 150 mg twice daily after 5–10 days of parenteral anticoagulation | For patients with CrCl >30 mL/min: 15 mg orally twice daily with food for the first 21 days for initial treatment 20 mg orally once daily with food for long-term treatment | NA | After 5–10 days of initial therapy with a parenteral anticoagulant
For patients with CrCl >50–≤95 mL/min: 60 mg once daily 30 mg once daily for patients with CrCl 15–50 mL/min or body weight less than or equal to 60 kg or who use certain P-gp inhibitors |
| To reduce the risk of recurrence of DVT and PE in patients who have been previously treated | For patients with CrCl >30 mL/min: 150 mg orally, twice daily | For patients with CrCl >30 mL/min: 15 mg orally twice daily with food for the first 21 days for initial treatment 20 mg orally once daily with food for remaining treatment, and the long-term reduction in risk of recurrent DVT or PE | NA | NA |
| Prophylaxis of DVT following hip or knee replacement | NA | For patients with CrCl >30 mL/min: 10 mg orally, once daily with or without food | 2.5 mg orally twice daily | NA |
CrCl, creatinine clearance; NA, not approved; NOACs, non-warfarin oral anticoagulants.