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