For a patient with atrial fibrillation and normal renal function, apixaban dose must be reduced to 2.5 mg twice daily if two of three specified criteria are present. Which set of criteria correctly defines these?
- A Age above 80 years, body weight below 60 kg, serum creatinine above 1.5 mg/dL ✓
- B Age above 75 years, diabetes, prior stroke
- C Age above 80 years, hypertension, heart failure
- D Body weight below 50 kg, serum creatinine above 2 mg/dL, age above 65 years
Correct answer: A. Age above 80 years, body weight below 60 kg, serum creatinine above 1.5 mg/dL
Explanation
The standard apixaban label specifies a reduced dose of 2.5 mg twice daily when any two of three criteria are met: age 80 years or older, body weight 60 kg or less, and serum creatinine 1.5 mg/dL or more. Options B and C describe stroke risk stratification (CHA2DS2-VASc components) rather than dosing criteria, which is the tempting distractor. This dose-reduction rule is distinct from the CHA2DS2-VASc score and must be memorised separately.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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