Practice question from Creatinine Clearance & Dose Adjustments

A 65-year-old female patient with atrial fibrillation has a CrCl of 22 mL/min. Which anticoagulant is the SAFEST choice? A. Dabigatran 150 mg twice daily B. Rivaroxaban 20 mg daily C. Apixaban 5 mg twice daily D. Edoxaban 60 mg daily E. Warfarin with INR monitoring

Answer

E

Explanation

At CrCl 22 mL/min, warfarin is the safest choice as it requires no renal dose adjustment. Dabigatran is contraindicated at <30 mL/min, and while other DOACs may technically be used with caution, warfarin remains the preferred agent at this level of severe renal impairment.

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