Direct oral anticoagulants (DOACs) are presented as a good option for older patients owing to their safety profile. However, the dosing of these drugs can become challenging. This is due to the fluctuation of renal function in this population, together with the presence of comorbidities and the concomitant use of other drugs, among other reasons. Prior studies reported high rates of nonstandard dosing in elderly patients, 1 Yao X. Shah N.D. Sangaralingham L.R. et al. Non-vitamin K antagonist oral anticoagulant dosing in patients with atrial fibrillation and renal dysfunction.

J Am Coll Cardiol. 2017; 69: 2779-2790

increasing the risk of adverse events. 2 On-label reduced doses of non-vitamin K anticoagulants prove safe and efficient; yet how to ensure the correct dose for the right patient?.

Eur Heart J. 2019; 40: 1501-1503