Abstract
Steady-state plasma concentrations of anticoagulants and the time since the previous administration in mainly outpatients with atrial fibrillation administered standard or reduced doses were analyzed for 110 elderly Japanese subjects (mean age, 76 years) treated with apixaban (2.5 or 5.0 mg twice daily), dabigatran etexilate (110 or 150 mg twice daily), edoxaban (30 or 60 mg once daily) or rivaroxaban (10 or 15 mg once daily) at one general hospital. The pharmacokinetics in patients treated with standard and reduced doses of the four anticoagulants using liquid chromatography-tandem mass spectrometry was compared with the concentration ranges estimated using physiologically based pharmacokinetic modeling. Reduced doses of anticoagulants resulted in relatively small pharmacokinetic variations compared with the standard dose. Statistical analyses revealed that renal impairment is likely not the sole determinant factor for high plasma concentrations of apixaban, dabigatran, edoxaban and rivaroxaban. Patients with atrial fibrillation should be treated with the correct doses of oral anticoagulants as specified in the package inserts (e.g. reduced doses for elderly patients, patients with low body weights and in combination with P-gl...Continue Reading
References
Oct 4, 2008·Drug Metabolism and Disposition : the Biological Fate of Chemicals·Nirmala RaghavanDonglu Zhang
Nov 3, 2010·British Journal of Clinical Pharmacology·Dagmar KubitzaHeike Bruck
Feb 16, 2011·International Heart Journal·You MiyagataYoshiki Sugiyama
Oct 1, 2011·Journal of Clinical Pharmacology·Thorsten LehrJeffrey Friedman
Oct 1, 2011·Journal of Clinical Pharmacology·Sudharshan Hariharan, Rajanikanth Madabushi
Oct 7, 2011·Journal of Thrombosis and Haemostasis : JTH·K-H LiesenfeldA Staab
Feb 8, 2013·Clinical Pharmacokinetics·Jochen Graff, Sebastian Harder
Feb 24, 2015·Thrombosis Journal·Sebastian Harder
May 20, 2015·Thrombosis Research·D M Adcock, R Gosselin
Dec 2, 2015·Clinical Pharmacokinetics·Dolly A Parasrampuria, Kenneth E Truitt
Apr 27, 2016·Journal of Thrombosis and Thrombolysis·Wan-Li ZhangHuan-Jie Huang
Jun 18, 2016·Journal of the American College of Cardiology·Kevin E ChanJonathan P Piccini
Nov 18, 2016·Xenobiotica; the Fate of Foreign Compounds in Biological Systems·Makiko ShimizuHiroshi Yamazaki
Feb 2, 2017·Xenobiotica; the Fate of Foreign Compounds in Biological Systems·Miho Yamazaki-NishiokaHiroshi Yamazaki
Apr 11, 2017·Journal of Atherosclerosis and Thrombosis·Mashio NakamuraMasaaki Ito
Feb 18, 2018·European Journal of Clinical Pharmacology·Ruijuan XuQing Jiang
May 1, 2018·Xenobiotica; the Fate of Foreign Compounds in Biological Systems·Tomonori MiuraHiroshi Yamazaki
May 14, 2018·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Deborah K Rose, Barak Bar
Jun 8, 2018·The Journal of Toxicological Sciences·Norie MurayamaHiroshi Yamazaki
Citations
May 29, 2020·Circulation Journal : Official Journal of the Japanese Circulation Society·Wanwarang WongcharoenArintaya Phrommintikul
Sep 19, 2020·Journal of Pharmaceutical Health Care and Sciences·Koichiro AdachiHiroshi Yamazaki
Feb 4, 2021·Journal of Pharmaceutical Health Care and Sciences·Koichiro AdachiHiroshi Yamazaki