Table 3 Metabolism of the TSOACs

Renal Impairment

6 fold higher exposure when CrCL 10–30 ml/min

1.6 fold higher exposure when CrCL 15-29

1.44 fold higher exposure when CrCL 15-29

Age

Age > 75 = 30% increase in trough concentrations

Mean AUC 1.5 fold higher in age > 65

Mean AUC 1.3 fold higher in age > 65

Hepatic Impairment

N/A

2.3 fold increase exposure in Child-Pugh B

N/A

Drug-drug interactions

Avoid strong inhibitors or inducers of p-glycoprotein

Avoid strong inhibitors of p-glycoprotein and CYP 3A4

Avoid strong inhibitors of p-glycoprotein and CYP 3A4