- Most patients are eligible for 1 month of a free DOAC prescription fill using prescription assistance cards
- Check state or individual Medicaid formulary, one specific DOAC may be covered while others are not
Guideline Recommendation for DOAC as first line therapy:
Use of a direct oral anticoagulant (apixaban, dabigatran, edoxaban or rivaroxaban) is considered first line therapy for treatment of acute PE and deep vein thrombosis and is recommended preferentially over warfarin therapy. (American College of Chest Physicians Guideline, 2016).
Reference: Chest 2016; 149:315-352.
Renal Function and DOACs:
Renal function (serums creatinine and/or creatinine clearance) should be followed regularly to ensure appropriate dosing. We recommend using the Cockcroft Gault Calculator that uses actual body weight to assess renal function. We advise against using the ideal body weight as this can lead to incorrect dosing.
Online calculator for Creatinine Clearance (using age, gender, weight and serum creatinine): http://nephron.com/cgi-bin/CGSI.cgi
Acute massive pulmonary embolism (HCC)
Acute saddle pulmonary embolism (HCC)
Acute saddle pulmonary embolism with acute cor pulmonale
Acute saddle pulmonary embolism without acute cor pulmonale
Other acute pulmonary embolism with acute cor pulmonale
Other acute pulmonary embolism without acute cor pulmonale