Appropriateness of direct oral anticoagulant dosing in patients with atrial fibrillation according to the drug labelling and the EHRA Practical Guide

•33.6% of patients had potential drug-drug interactions with DOAC.•18.3% of patients received inappropriate DOAC dose according to the drug labelling.•23.4% of patients received inappropriate DOAC dose according to the EHRA Practical Guide.•Inconsistencies between drug labelling and EHRA were identified in almost 10% of patients.•Appropriate DOAC dosing in this ‘grey zone’ population is unclear.