Edoxaban

SAVAYSA

Open Edoxaban in the interactive console ↗

What it isDirect factor Xa inhibitor; atrial-fibrillation stroke prevention and venous thromboembolism treatment.

Why this oneUnlike other DOACs, it loses efficacy in atrial fibrillation above CrCl 95 mL/min and should not be used there.

What limits it⚑ Bleeding remains central; interruption raises thrombosis risk, and P-glycoprotein inhibitors increase exposure.

FDA-approved for

stroke prevention in AF/VTE (2015)

FDA label

Read the full label on DailyMed ↗

BOXED WARNING (A) Reduced efficacy in NVAF with CrCL >95 mL/min; (B) premature discontinuation increases ischemic events; (C) spinal/epidural hematoma with neuraxial anesthesia/puncture.

FDA dosing	Population	Start	Target	Max
Nonvalvular atrial fibrillation	Adults (CrCL >50 to ≤95)	60 mg QD	60 mg QD	60 mg QD
DVT/PE treatment	Adults	60 mg QD after 5-10 days parenteral anticoagulant	60 mg QD	60 mg QD

Renal CrCL 15-50 mL/min: 30 mg QD; NVAF with CrCL >95: do not use; CrCL <15: not recommended

Hepatic Moderate-severe (Child-Pugh B/C): not recommended; mild (A): no adjustment

DVT/PE: reduce to 30 mg QD if CrCL 15-50, body weight ≤60 kg, or certain P-gp inhibitors

Instructions

Take without regard to food
May crush and mix with water or applesauce and give immediately
If a dose is missed, take it the same day; do not double the dose

Contraindications

Active pathological bleeding

Cautions

Serious/fatal bleeding; no established reversal agent
Reduced efficacy at CrCL >95 mL/min (NVAF)
Increased stroke risk on premature discontinuation
Spinal/epidural hematoma
Not recommended with mechanical heart valves or moderate-severe mitral stenosis
Not recommended in triple-positive antiphospholipid syndrome

Adverse reactions

Bleeding
Anemia
Rash
Abnormal liver function tests

Pregnancy Insufficient data; may increase fetal/neonatal bleeding risk.

Lactation Breastfeeding not recommended.

⚠ BOXED WARNINGS

Reduced efficacy in nonvalvular AF with CrCl >95 mL/min
Premature discontinuation increases thrombotic risk
Spinal or epidural hematoma

Cost, est. cash$500–$750/month

Generic entry2028 est.

Classes and tags

Clinical profile

Therapeutic safety burden3 / 4

Overdose danger3 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk2 / 4

Legacy pregnancy categoryUnknown / historical label unavailable

Defining liabilityMajor bleeding; renal function, age and interacting drugs materially influence risk.

Mechanism of action: Edoxaban ballicule

Edoxaban ballicule: receptor binding, kinetics and half-life diagram

Open Edoxaban in the interactive console ↗

Memory aids: mascots and interaction avatars

Edoxaban SAVAYSA mascot mnemonic cartoon — **“Saved — eDocs are banned”**

P-gp substrate (sensitive)

Open Edoxaban in the interactive console ↗