Approximate time prior to surgery or invasive procedure for which anticoagulant drug should be stopped. National4 and local guidelines and product literature should be consulted for specific details
| Drug | Duration between stopping and invasive procedure or surgery | Duration before stopping and invasive procedure or surgery in impaired renal function – creatinine clearance <30 | ||
|---|---|---|---|---|
| Low bleeding risk procedure | High bleeding risk procedure | Low bleeding risk procedure | High bleeding risk procedure | |
| Warfarin | 5 days | |||
| UFH | 4 hours | |||
| LMWH | Prophylactic dose, 12 hours | If used, discuss dose and timing with haematology | ||
| Treatment dose, 24 hours | ||||
| Fondaparinux | 24–42 hours | If used, discuss dose and timing with haematology | ||
| Argatroban | 4 hours | |||
| Dabigatran | 24 hours | 48 hours | Cr Cl > 50 to <80: 24–48 hours | Cr Cl > 50 to < 80: 48–72 hours |
| Cr Cl > 30 to <50: 48–72 hours | Cr Cl > 30 to <50: 72–96 hours | |||
| Apixaban | 24 hours | 48 hours | 48 hours | 72 hours |
| Edoxaban | 24 hours | 48 hours | 48 hours | 72 hours |
| Rivaroxaban | 24 hours | 48 hours | 48 hours | 72 hours |
LMWH = low-molecular-weight heparin; UFH = unfractionated heparin