Rivaroxaban should be avoided when CrCl is below which threshold?

• A. 50 mL/min
• B. 15 mL/min
• C. 20 mL/min
• D. 30 mL/min

Answer: (A)

Renal function drives the safety of rivaroxaban in older adults. Because rivaroxaban is partially cleared by the kidneys, reduced creatinine clearance means higher drug exposure and a greater risk of bleeding, with limited evidence to support safe dosing in that range. The Beers Criteria thus flags rivaroxaban as something to avoid when creatinine clearance falls below 50 mL/min, to minimize harm from anticoagulation in this population.