Table 1 Dose reduction criteria of dabigatran, rivaroxaban, apixaban, and edoxaban in our study

150 mg twice daily

15 mg once daily

5 mg twice daily

60 mg once daily

110 mg twice daily

10 mg once daily

2.5 mg twice daily

30 mg once daily

Dose reduction criteria

Renal function

CrCl 30 to 50 mL/min

CrCl 15 to 49 mL/min

≥2 of the following: Serum creatinine ≥1.5 mg/dL

CrCl 15 to 50 mL/min

Age

Age ≥ 70 years

Age ≥ 80 years

Body weight

Body weight ≤ 60 kg

Body weight ≤ 60 kg

P-gp inhibitors (quinidine, verapamil, amiodarone, tacrolimus, cyclosporine, ritonavir, nelfinavir, saquinavir)

CYP 3A4 and P-gp inhibitors (fluconazole, fosfluconazole, clarithromycin, erythromycin)

CYP 3A4 and P-gp inhibitors [Azole antifungal agents (except for fluconazole)] and HIV protease inhibitors]

P-gp inhibitors (quinidine, verapamil, cyclosporine, erythromycin, azithromycin, clarithromycin, itraconazole, diltiazem, amiodarone, HIV protease inhibitors)

Other

History of GIH