Table 1.

Dose Reduction Criteria for DOAC

	Dabigatran†	Rivaroxaban	Apixaban	Edoxaban
USA
Standard dose/ reduced dose	150/75 mg twice daily	20/15 mg once daily	5/2.5 mg twice daily	60/30 mg once daily
Criteria for dose reduction	CrCl 15–30 mL/min; Concomitant use of P-gp inhibitors in patients with moderate renal impairment (CrCl <15 mL/min)	CrCl 15–50 mL/min	Patients with ≥2 of the following characteristics: age ≥80 years; serum creatinine ≥1.5 mg/dL; body weight ≤60 kg	CrCl 15–50 mL/min
Avoid	Creatinine clearance <15 mL/min	CrCl <15 mL/min	CrCl <15 mL/min	CrCl <15 mL/min; CrCl >95 mL/min; Concomitant use of rifampin
Japan
Standard dose/ reduced dose	150/110 mg twice daily	15/10 mg once daily	5/2.5 mg twice daily	60/30 mg once daily
Criteria for dose reduction	Elderly >70 years; CrCl 30–50 mL/min; Concomitant use of P-gp inhibitors; History of GI bleeding	CrCl 15–49mL/min	Patients with ≥2 of the following characteristics: age ≥80 years; serum creatinine ≥1.5 mg/dL; body weight ≤60 kg	Body weight ≤60 kg; CrCl 15–50 mL/min; Concomitant use of P-gp inhibitors
Avoid	CrCl <30 mL/min	CrCl <15 mL/min	CrCl <15 mL/min	CrCl <15 mL/min

^†Dose reduction recommended when the criteria are met. CrCl, creatinine clearance; GI, gastrointestinal; P-gp, P-glycoprotein.