Do I reduce the dose if only one criterion is present?

No. The label requires two of the three criteria before the AF dose drops to 2.5 mg twice daily. A single criterion — for example an 82-year-old who weighs 78 kg with a creatinine of 1.1 mg/dL — stays on 5 mg twice daily. Under-dosing on the basis of age alone is a common and avoidable error.

Is the reduction rule the same for treating a DVT or PE?

No. Venous thromboembolism treatment starts at 10 mg twice daily for seven days, then 5 mg twice daily, and the three AF criteria do not apply. The only renal stop for VTE is a creatinine clearance below 25 mL/min, where apixaban is not recommended.

What about patients on dialysis?

The FDA label does not recommend apixaban for AF in patients on dialysis, and the dose-reduction criteria were derived in patients with preserved renal function. Use in end-stage renal disease is an off-label decision that belongs with nephrology and cardiology, not with a calculator.

Apixaban 2.5 mg Twice Daily: Who Qualifies?

The apixaban label reduces the AF dose to 2.5 mg twice daily when two of three criteria are met — age 80 or older, weight 60 kg or less, creatinine 1.5 mg/dL or higher. This page applies the rule and flags the cases where it does not apply.

Reduce to 2.5 mg twice daily when at least two of: age ≥ 80 years, weight ≤ 60 kg, serum creatinine ≥ 1.5 mg/dL. Source: apixaban US prescribing information (ELIQUIS).

Age (years)

Weight (kg)

Serum creatinine (mg/dL)

Sex (for Cockcroft-Gault CrCl)

5 mg twice daily

Standard dose — 0 of 3 criteria met

Criterion	Status
Age ≥ 80 years	Not met
Weight ≤ 60 kg	Not met
Serum creatinine ≥ 1.5 mg/dL	Not met

Estimated creatinine clearance (Cockcroft-Gault): 73.7 mL/min. The label criteria use serum creatinine directly; CrCl is shown for supporting context only.

Clinical Guidance

For nonvalvular atrial fibrillation, apixaban is dosed at 5 mg twice daily. The dose is reduced to 2.5 mg twice daily when at least two of three criteria are present: age 80 years or older, body weight 60 kg or less, or serum creatinine 1.5 mg/dL or higher. Meeting only one criterion does not trigger reduction.

This calculator is an educational aid and does not replace clinical judgement. Confirm the current product label, review interacting medications and renal function, and individualise therapy before prescribing.

How to Use

Enter the values for the scenario you are assessing. The apixaban label reduces the AF dose to 2.5 mg twice daily when two of three criteria are met — age 80 or older, weight 60 kg or less, creatinine 1.5 mg/dL or higher. This page applies the rule and flags the cases where it does not apply. Use the apixaban dose reduction result to inform your calculation.

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