Edoxaban

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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
  • 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

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.

See Also

References