Edoxaban
Administration
- Type: Anticoagulant
- Dosage Forms: 15, 30, 60 mg
- Routes of Administration: Oral
- Common Trade Names: Savaysa
Adult Dosing
Thromboembolism/stroke Prophylaxis
- 60 mg PO QD
DVT/PE Treatment
- <60 kg
- 30 mg PO QD
- >60 kg
- 60 mg PO QD
Pediatric Dosing
N/A
Special Populations
- Pregnancy Rating: D; Avoid use (Risk of maternal hemorrhage and embryo-fetal death up to 49xMRHD based on animal data and risk of maternal/fetal bleeding base don mechanism of action; No known risk of teratogenicity)
- Lactation risk: L3; Safety unknown
Renal Dosing
- Adult:
- Thromboembolism/stroke Prophylaxis
- CrCl > 95: Avoid Use
- CrCl 50-95: No Adjustment
- CrCl 15-50: 30 mg QD
- CrCl <15 (not on HD): Avoid use
- DVT/PE treatment
- CrCl 15-30: 30 mg QD
- Cr Cl <15 (not on HD): Avoid use
- Thromboembolism/stroke Prophylaxis
- Pediatric: N/A
Hepatic Dosing
- Adult: Child-Pugh Class B or C: Avoid use
- Pediatric: N/A
Contraindications
- Allergy to class/drug
- Hypersenstivity to drug/class/component
- Active major bleeding
- CrCl > 95 (non-valvular atrial fibrillation patients)
- CrCl < 15
- Hepatic impairment (Child-Pugh Class B or C)
Adverse Reactions
Serious
- Epidural hematoma
- Bleeding, severe
- Thrombosis with premature D/C
Common
Pharmacology
- Half-life: 10-14 hr
- Metabolism: Minimal; CYP450: 3A4 substrate
- Excretion: Urine 50%
Mechanism of Action
- Factor Xa inhibitor
Comments
- Black Box Warnings:
- Reduced Efficacy in non-valvular Afib Pts with CrCl >95mL/min with increased risk for ischemic stroke
- Premature treatment discontinuation increases the risk of increased ischemic event for reasons other than pathological bleeding or course completion
- Epidural/Spinal Hematoma Risk after anesthesia or spinal puncture may result in long-term or permanent paralysis and increases.