What is the anticoagulant of choice for obese patients?

In patients with a BMI of 40-50 kg/m2, warfarin should be used, but apixaban or edoxaban can be considered. In obese patients with a BMI > 50 kg/m2, warfarin should be used.

Can DOACs be used in obese patients?

However, despite the clear advantages, DOACs are not often used in morbidly obese patients. The International Society of Thrombosis and Haemostasis (ISTH) recommends against DOAC use in patients with a body mass index (BMI)≥40 kg·m−2 or weight>120 kg because of the lack of available safety and efficacy data.

Can apixaban be used in obese patients?

Among obese patients, apixaban was associated with a significantly lower risk of recurrent VTE (HR: 0.73; 95% CI: 0.64–0.84), MB (HR: 0.73; 95% CI: 0.62–0.85), and CRNM bleeding (HR: 0.82; 95% CI: 0.77–0.88) compared to warfarin (Figure 3).

Can Xarelto be used in obese patients?

The Janssen Pharmaceutical Companies of Johnson & Johnson has announced the publication of new real-world evidence which confirms that XARELTO (rivaroxaban) reduces the risk of recurrent venous thromboembolism (VTE) in patients who are morbidly obese, with effectiveness and safety similar to that of warfarin.

Do obese patients need more warfarin?

One of these variables is body weight since we have shown that obese patients require higher warfarin doses to achieve a therapeutic INR level.

Is there a weight limit for taking eliquis?

Therefore, the guidance suggested that DOACs not be used in patients with a BMI > 40 kg/m2 or a weight >120 kg, but that if a DOAC is used in these patients, a peak and trough level should be obtained to ensure the levels fall within the expected range.

What is the most frequently reported error involving anticoagulant therapy?

The most frequent error type without harm was duplicate anticoagulation therapy (33.3%), and others included dose omission, wrong dose, and procedure cancellation.

Is eliquis based on weight?

No dose adjustment is recommended for apixaban based on body weight alone; however, caution is warranted in the presence of additional factors (such as severe renal impairment) that increase apixaban exposure.

How do you treat obese VTE?

In our experience, treatment of acute VTE in patients who are morbidly obese is most safely achieved by using intravenous unfractionated heparin and concomitant warfarin.

Does obesity affect INR?

Based on limited information available, some data have demonstrated that obesity is associated with higher warfarin requirements to achieve a therapeutic INR due to a higher volume of distribution related to fat solubility and increased clearance.

Does BMI affect warfarin?

We found that BMI is positively correlated with the total weekly warfarin dose. Our study showed that for each 1-point increase in BMI, the weekly warfarin dose increased by 0.69 mg. We found that the average warfarin weekly dose in this population can be estimated using the formula: 12.34 + 0.69 × BMI.

What weight should you be to take apixaban?

The recommended dose of apixaban is 2.5 mg taken orally twice daily in patients with NVAF and at least two of the following characteristics: age ≥ 80 years, body weight ≤ 60 kg, or serum creatinine ≥ 1.5 mg/dL (133 micromole/L).