Would you use new DOAC loading dose or start with maintenance dosing for a stable patient on existing DOAC who needs to switch brand due to insurance/formulary reasons?

Conversion tables suggest starting the new drug with the next dose but do not seem to answer this question (i.e. if switching from rivaroxaban 20 mg daily, do you start apixaban 5mg BID dose or start with 10mg BID x 1 week?)

Answer from: at Community Practice

For some drugs, you need to do a loading dose to get the drugs to therapeutic levels. However, with DOACs, a loading dose is used at the time of VTE diagnosis and therapy initiation to jump start the anticoagulant effect when the clot burden is the highest. Thus, if you are switching from another fu...

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Would you use new DOAC loading dose or start with maintenance dosing for a stable patient on existing DOAC who needs to switch brand due to insurance/formulary reasons?

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