Key result
Apixaban 2.5 mg BID in ESRD linked to supratherapeutic anti-Xa levels and GI bleeding.
Case Report (n=1)
Apixaban 2.5 mg twice daily in a patient with ESRD on hemodialysis resulted in supratherapeutic drug levels and gastrointestinal bleeding, raising concerns about current dosing recommendations.
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Warrants caution with apixaban 2.5 mg BID in ESRD on hemodialysis; case report leaves open optimal dosing and monitoring strategies.
Kufel et al. (2016) conducted a case report in Nonvalvular atrial fibrillation and end-stage renal disease requiring hemodialysis (n=1). Apixaban was evaluated on Gastrointestinal bleeding and antifactor Xa concentrations. Administration of apixaban 2.5 mg twice daily in a patient with ESRD on hemodialysis led to supratherapeutic antifactor Xa levels (>2.00 IU/ml) and gastrointestinal bleeding on day 7.
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