[Answered]: a 57 year old woman ( wt 148kg, ht 75 inches,…

a 57 year old woman ( wt 148kg, ht 75 inches, CrCl 62 mL/min) has a history of unprovoked DVT and pulmonary embolism (PE) ( 3 years ago). She has now experienced a new DVT caused by sub therapeutic INRs while on warfarin and presents for her first anticoagulation management visit. She states she is adherent to warfarin therapy, but she is unable to come to appointments regularly because of limited mobility caused by arthritis. You are asked for a recommendation regarding discontinuing this patient’s warfarin in favor of a DOAC. Which one of the following is best to recommend for this patient? A DOAC is not recommended because of her obesity Apixaban 10mg twice daily for 7 days, then 5mg twice daily Edoxaban 30mg daily; no LMWH is required Rivaroxaban is contraindicated because of her renal function