Table 1.

Edoxaban: summary information

Mode of action	Direct inhibitor of factor Xa
Indication/license	Treatment of DVT or PE and prevention of recurrence of symptomatic VTE Prevention of stroke and systemic embolic events in patients with AF
Dosage	30–60 mg
Dose regimen	Once daily
Reversal	Specific reversal not available. Consider prothrombin complex concentrate in emergency setting
Monitoring	No routine monitoring required
Periprocedure management	Edoxaban should be discontinued a minimum of 12 hours prior to procedure, and enoxaparin commenced at the same time as the next scheduled NOAC dose
Prodrug	None; edoxaban is a direct factor Xa inhibitor and active upon administration
Half-life	10–14 hours
Peak serum levels	1–2 hours
Excretion	Excretion predominantly in feces and urine Approximately 35% renal elimination
Use in pregnancy	Not recommended. Risks cannot be ruled out at present
Reduces efficacy of edoxaban, risk of stroke/embolism	CYP3A4 and P-gp inhibitors: HIV protease inhibitors, itraconazole, ketoconazole, clarithromycin
Increases edoxaban serum levels, risk of bleeding	CYP3A4 and P-gp inducers: carbamazepine, phenytoin, rifampicin Avoid edoxaban administration
Dose in renal impairment	50% dose reduction if GFR is 15–29 mL/min Do not use if GFR <15 mL/min
Bridging	Edoxaban should be discontinued and enoxaparin commenced at the same time as the next scheduled NOAC dose For conversion to warfarin, edoxaban should be discontinued once the patient’s INR is in therapeutic range
Monitoring	aPTT and PT and anti-factor Xa are all sensitive to edoxaban concentrations

Abbreviations: DVT, deep vein thrombosis; PE, pulmonary embolism; VTE, venous thromboembolism; P-gp, p-glycoprotein; AF, atrial fibrillation; GFR, glomerular filtration rate; NOAC, new oral anticoagulant; INR, international normalized ratio; aPTT, activated partial thromboplastin time; PT, prothrombin time.