{
  "abstract": "Background and Importance Our medical record estimate creatinine clearance (Cl CR) only according to CKD-EPI formula. However, according to edoxaban and dabigatran product information, Cockcroft-Gault formula should be used to estimate ClCR and possible dose adjustments.For edoxaban, dose adjustment according to ClCR is specified, while for dabigatran, the only clearly established indication is the contraindication when ClCR<30 mL/min.Aim and Objectives To identify discrepancies between the recommended dose of edoxaban and dabigatran depending on the formula used to estimate Cl CR.Material and Methods Cross-sectional observational study. Adult patients treated with edoxaban or dabigatran for atrial fibrillation (AF) in July 2025 were included. Data collected age, sex, weight, serum creatinine (Scr), Cl CR according to CKD-EPI, dialysis treatment and concomitant treatments with cyclosporine, dronedarone, erythromycin or ketoconazole (P-glycoprotein inhibitors). ClCR was calculated using Cockcroft-Gault. Patients with weight and/or Scr records prior to August 2024 and those who were treated with edoxaban weighting ≤60 kg or receiving concomitant treatment with P-glycoprotein inhibitors were excluded.Anticoagulant doses were calculated based on both estimating formulas, and differences were checked.Edoxaban differences were classified as: overdose, underdose, should be contraindicated, should not be contraindicated. For dabigatran: should be contraindicated, should not be contraindicated.Results We included 2493 patients (35.7% women), median age 79 years (range 40–101). Approximately 2/3 were treated with edoxaban (65.4%), while 34.6% were in treatment with dabigatran. No patients were on dialysis.In 1449 patients treated with edoxaban (88.9%) the dose did not change regardless of the formula used. In the remaining patients (181; 11.1%) dose should be reduced from 60 to 30 mg (123; 68.0%) or increased from 30 to 60 mg (58; 32.0%).In any case, the contraindication recommendations varied according to the formula used in patients treated with edoxaban or dabigatran.Conclusion and Relevance Using CKD-EPI formula instead of Cockcroft-Gault, 11.1% patients treated with edoxaban for AF would be over (2/3 patients) or under-dosed (1/3) according to the estimating formula. No contraindication recommendation differences were found in patients treated with dabigatran or edoxaban.It would be advisable for regulatory agencies to issue clear recommendations on dosing with the available estimation formulas.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Subdirección De Farmacia Y Prestaciones- Servicio Navarro De Salud-Osasunbidea Sns-O, Servicio De Asesoría E Información Del Medicamento, Pamplona, Spain"
      ],
      "name": "A Rodríguez Esquíroz"
    },
    {
      "affiliations": [
        "Subdirección De Farmacia Y Prestaciones- Servicio Navarro De Salud-Osasunbidea Sns-O, Servicio De Gestión De La Prestación Farmacéutica, Pamplona, Spain"
      ],
      "name": "O Goñi Zamarbide"
    },
    {
      "affiliations": [
        "Subdirección De Farmacia Y Prestaciones- Servicio Navarro De Salud-Osasunbidea Sns-O, Servicio De Asesoría E Información Del Medicamento, Pamplona, Spain"
      ],
      "name": "L García López"
    },
    {
      "affiliations": [
        "Subdirección De Farmacia Y Prestaciones- Servicio Navarro De Salud-Osasunbidea Sns-O, Servicio De Asesoría E Información Del Medicamento, Pamplona, Spain"
      ],
      "name": "J Gorricho Mendivil"
    },
    {
      "affiliations": [
        "Subdirección De Farmacia Y Prestaciones- Servicio Navarro De Salud-Osasunbidea Sns-O, Servicio De Asesoría E Información Del Medicamento, Pamplona, Spain"
      ],
      "name": "A Echeverría Gorriti"
    },
    {
      "affiliations": [
        "Subdirección De Farmacia Y Prestaciones- Servicio Navarro De Salud-Osasunbidea Sns-O, Servicio De Asesoría E Información Del Medicamento, Pamplona, Spain"
      ],
      "name": "M Marin Marin"
    },
    {
      "affiliations": [
        "Subdirección De Farmacia Y Prestaciones- Servicio Navarro De Salud-Osasunbidea Sns-O, Servicio De Asesoría E Información Del Medicamento, Pamplona, Spain"
      ],
      "name": "J Fernández González"
    },
    {
      "affiliations": [
        "Subdirección De Farmacia Y Prestaciones- Servicio Navarro De Salud-Osasunbidea Sns-O, Servicio De Asesoría E Información Del Medicamento, Pamplona, Spain"
      ],
      "name": "L Sanz Alvarez"
    },
    {
      "affiliations": [
        "Subdirección De Farmacia Y Prestaciones- Servicio Navarro De Salud-Osasunbidea Sns-O, Servicio De Asesoría E Información Del Medicamento, Pamplona, Spain"
      ],
      "name": "J Garjon Parra"
    }
  ],
  "title": "5PSQ-005 Edoxaban and dabigatran dosage: is the estimating creatinine clearance formula important?",
  "uid": "3c3d9120-8f4d-5dd4-bed6-7d00f856ee71"
}