![]() It is recommended that during the first 14 days of concomitant therapy the INR is measured at least 3 times just prior to taking the daily dose of edoxaban to minimise the influence of edoxaban on INR measurements. After 14 days it is recommended that edoxaban is discontinued and the VKA continued to be titrated to achieve an INR between 2 and 3. Most patients (85%) should be able to achieve an INR ≥ 2.0 within 14 days of concomitant administration of edoxaban and VKA. Once an INR ≥ 2.0 is achieved, edoxaban should be discontinued. It is recommended to take into account the maintenance dose of VKA and if the patient was previously taking a VKA or to use valid INR driven VKA treatment algorithm, in accordance with local practice. ![]() Patients should not take a loading dose of VKA in order to promptly achieve a stable INR between 2 and 3. ![]() Oral option: For patients currently on a 60 mg dose, administer an edoxaban dose of 30 mg once daily together with an appropriate VKA dose.įor patients currently on a 30 mg dose (for one or more of the following clinical factors: moderate to severe renal impairment (CrCl 15 – 50 mL/min), low body weight, or use with certain P-gp inhibitors), administer an edoxaban dose of 15 mg once daily together with an appropriate VKA dose. Continuous adequate anticoagulation should be ensured during any transition to an alternate anticoagulant. There is a potential for inadequate anticoagulation during the transition from edoxaban to VKA. Intravenous unfractionated heparin (UFH):ĭiscontinue the infusion and start edoxaban 4 hours later. low molecular weight heparin (LMWH), fondaparinux):ĭiscontinue subcutaneous anticoagulant and start edoxaban at the time of the next scheduled subcutaneous anticoagulant dose. These medicinal products should not be administered simultaneously. Table 1: Summary of posology in NVAF and VTE (DVT and PE)ĭiscontinue the VKA and start edoxaban when the international normalised ratio (INR) is ≤ 2.5.ĭiscontinue dabigatran, rivaroxaban or apixaban and start edoxaban at the time of the next dose of the oral anticoagulant (see section 5.1). Concomitant use of the following P-glycoprotein (P-gp) inhibitors: ciclosporin, dronedarone, erythromycin, or ketoconazole.Moderate or severe renal impairment (creatinine clearance (CrCl) 15 - 50 mL/min).recent surgery, trauma, immobilisation) and longer durations should be based on permanent risk factors or idiopathic DVT or PE.įor NVAF and VTE the recommended dose is 30 mg edoxaban once daily in patients with one or more of the following clinical factors: Short duration of therapy (at least 3 months) should be based on transient risk factors (e.g. The duration of therapy for treatment of DVT and PE (venous thromboembolism (VTE)), and prevention of recurrent VTE should be individualised after careful assessment of the treatment benefit against the risk for bleeding (see section 4.4). ![]() Edoxaban and initial parenteral anticoagulant should not be administered simultaneously. The recommended dose is 60 mg edoxaban once daily following initial use of parenteral anticoagulant for at least 5 days (see section 5.1). Treatment of DVT, treatment of PE and prevention of recurrent DVT and PE (VTE) Therapy with edoxaban in NVAF patients should be continued long term. The recommended dose is 60 mg edoxaban once daily. Prevention of stroke and systemic embolism Date of first authorisation/renewal of the authorisation
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