New practice guide for DOACs in renal impairment
A new practice guide from the NHS Specialist Pharmacy Service provides practical advice on selecting the correct dose of direct acting oral anticoagulants (DOACs) in patients being treated for atrial fibrillation and renal impairment.
The guide, published in November, will be useful to medical and non-medical prescribers and the wider pharmacy community working in both primary and secondary care who will prescribing or checking the dose of DOAC prescribed for their patients.
The resource discusses dosing in renal impairment (excluding dialysis patients and patients with a Creatinine clearance <15 ml/minute), limitations of the Cockcroft and Gault equation and illustrates some of the creatinine clearance calculation tools available. Real life examples are given to illustrate the implications for dose selection. Pharmacy teams are ideally placed to play a key role in both primary and secondary care in ensuring the safe prescribing, on-going monitoring and where necessary dose adjustment of DOACs.
The new guide can be found at https://www.sps.nhs.uk/wp-content/uploads/2018/11/Dosing-of-DOACs-in-renal-impairment-FINAL-14.11.pdf
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