Anticoagulation to prevent thromboembolic events in patients with atrial fibrillation and obesity
For patients with atrial fibrillation who weigh up to 120 kg or have a body mass index (BMI) of up to 40 kg/m2, standard direct-acting oral anticoagulant (DOAC) therapy to prevent thromboembolic events may be considered; rivaroxaban and apixaban have the strongest evidence for use in this setting. See Direct-acting oral anticoagulants to prevent thromboembolic events in atrial fibrillation for dosages.
For patients with atrial fibrillation who weigh more than 140 kg or have a BMI of 50 kg/m2 or more, data are limited to guide dosages of DOACs. Under specialist advice, consider assessing DOAC plasma concentration or switching to warfarin.