American Board of Internal Medicine (ABIM) Certification Practice Exam

What serum creatinine level is a criterion for adjusting apixaban dosage?

1. 1.0 mg/dL

2. 1.2 mg/dL

3. 1.5 mg/dL

4. 1.8 mg/dL

The correct answer is: 1.5 mg/dL

In the context of adjusting apixaban dosage based on renal function, a serum creatinine level of 1.5 mg/dL is significant. This threshold is crucial because apixaban is primarily cleared through the renal system, and its dosing must be adjusted to minimize the risk of bleeding in patients with compromised kidney function. According to clinical guidelines, if the serum creatinine level is 1.5 mg/dL or greater, the recommended dose of apixaban may need to be reduced to ensure safety and efficacy. For individuals with a serum creatinine level below this threshold, the standard dosing would typically be appropriate. Therefore, understanding this critical cutoff helps healthcare providers ensure patients receive the correct dosage that aligns with their renal clearance, thereby optimizing treatment outcomes.