This case highlights the importance of closely examining renal function and concurrent renally cleared medications before starting DOACs like rivaroxaban.
Rivaroxaban (Xarelto; Johnson however, the assays required for such monitoring are not readily available. Herein, we present a case of a 68-year-old Caucasian male patient who was receiving rivaroxaban (20 mg/day) for atrial flutter and had mild renal impairment. The patient was found to have increased effect of rivaroxaban due to further impairment of renal clearance caused by several renally cleared medications. This case highlights the importance of closely examining the renal function of and medication list for a patient before starting DOACs such as rivaroxaban.
Milito et al. (2019) studied this question.