Adults

The usual recommended dose for Edoxaban is 60 mg once daily. However, a reduced dose of 30 mg once daily is typically recommended for patients with moderate to severe renal impairment (CrCl 15-50 mL/min), body weight ≤ 60 kg, or concomitant use of certain P-gp inhibitors. A 20 mg dose may be prescribed in specific cases of severe renal impairment or other patient-specific factors as determined by a physician.

Elderly

No specific dose adjustment based solely on age is required, but renal function should be assessed, and dose adjusted as per renal impairment guidelines.

Renal_impairment

For patients with CrCl 15-50 mL/min, a reduced dose of 30 mg once daily is usually recommended. For CrCl < 15 mL/min or on dialysis, Edoxaban is generally not recommended due to insufficient clinical data. A 20 mg dose may be considered by a physician in very specific, severe cases.

Onset

Anticoagulant effect observed within 1-2 hours.

Excretion

Eliminated predominantly by renal (approximately 50%) and biliary/fecal (approximately 50%) excretion.

Half life

Approximately 10-14 hours.

Absorption

Rapidly absorbed after oral administration, with peak plasma concentrations reached in 1-2 hours. Absolute bioavailability is approximately 62%.

Metabolism

Minimally metabolized; primarily by hydrolysis, and to a lesser extent by CYP3A4/5 (<10%).

Antiplatelet agents (e.g., Aspirin, Clopidogrel, NSAIDs)

Increased risk of bleeding; use with caution.

Other anticoagulants (e.g., Warfarin, Heparin, other DOACs)

Increased risk of bleeding; generally contraindicated (except during switching protocol).

P-glycoprotein (P-gp) inducers (e.g., Rifampicin, Phenytoin, Carbamazepine, St. John's Wort)

Decrease Edoxaban plasma concentrations, potentially reducing efficacy. Concomitant use should be avoided.

P-glycoprotein (P-gp) inhibitors (e.g., Cyclosporine, Dronedarone, Erythromycin, Ketoconazole)

Increase Edoxaban plasma concentrations, requiring dose reduction to 30 mg once daily for some indications.