NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

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Edoxaban should not be used in patients with a CrCl higher than what value?

95 mL/min
50 mL/min
30 mL/min
15 mL/min

The correct answer is: 95 mL/min

Edoxaban is a direct oral anticoagulant used for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation and for the treatment and prevention of deep vein thrombosis and pulmonary embolism. It is primarily eliminated renally, with approximately 50% of the dose excreted in the urine. In patients with a creatinine clearance (CrCl) higher than 95 mL/min, the risk of edoxaban accumulating in the body increases due to its primarily renal elimination. This can lead to an increased risk of bleeding. Therefore, it is recommended not to use edoxaban in patients with a CrCl greater than 95 mL/min to avoid the potential for drug accumulation and associated adverse effects. Options B, C, and D are lower CrCl values, indicating a higher level of renal impairment. In patients with significantly reduced renal function (CrCl below 95 mL/min), the dose of edoxaban may need to be adjusted to prevent drug accumulation and potential bleeding complications.