Anticoagulant | Kidney function and dose | Interval between last dose and procedure NOTE: No anticoagulant is administered the day of the procedure | Resumption after procedure | ||
High bleeding risk | Low bleeding risk | High bleeding risk | Low bleeding risk | ||
Dabigatran | CrCl >50 mL/minute Dose 150 mg twice daily | Give last dose 3 days before procedure (ie, skip 4 doses on the 2 days before the procedure) | Give last dose 2 days before procedure (ie, skip 2 doses on the day before the procedure) | Resume 48 to 72 hours after surgery (ie, postoperative day 2 to 3) | Resume 24 hours after surgery (ie, postoperative day 1) |
CrCl 30 to 50 mL/minute Dose 150 mg twice daily | Give last dose 5 days before procedure (ie, skip 8 doses on the 4 days before the procedure) | Give last dose 3 days before procedure (ie, skip 4 doses on the 2 days before the procedure) | |||
Rivaroxaban | CrCl >50 mL/minute Dose 20 mg once daily | Give last dose 3 days before procedure (ie, skip 2 doses on the 2 days before the procedure) | Give last dose 2 days before procedure (ie, skip 1 dose on the day before the procedure) | ||
CrCl 30 to 50 mL/minute Dose 15 mg once daily | |||||
Apixaban | CrCl >50 mL/minute Dose 5 mg twice daily | Give last dose 3 days before procedure (ie, skip 4 doses on the 2 days before the procedure) | Give last dose 2 days before procedure (ie, skip 2 doses on the day before the procedure) | ||
CrCl ≤50 mL/minute Dose 2.5 mg twice daily | |||||
Edoxaban | CrCl 51 to 95 mL/minute Dose 60 mg once daily | Give the last dose 3 days before the procedure (ie, skip 2 doses on the 2 days before the procedure) | Give the last dose 2 days before the procedure (ie, skip 2 dose on the day before the procedure) | ||
CrCl ≤50 mL/minute* Dose 30 mg once daily |
CrCl: creatinine clearance.
* Product information varies in different countries regarding a lower limit of CrCl below which the drug should not be used. As an example, product information in the United States specifies avoiding use with CrCl <15 mL/minute.Do you want to add Medilib to your home screen?