Timing of interruption of dabigatran or rivaroxaban before surgery or invasive procedures
| Calculated creatinine clearance, mL/min . | Half-life, hours . | Timing of last dose before surgery . | |
|---|---|---|---|
| Standard risk of bleeding* . | High risk of bleeding† . | ||
| Dabigatran | |||
| > 80 | 13 (11-22) | 24 h | 2 d |
| > 50- ≤ 80 | 15 (12-34) | 24 h | 2 d |
| > 30- ≤ 50 | 18 (13-23) | 2 d | 4 d |
| ≤ 30 | 27 (22-35) | 4 d | 6 d |
| Rivaroxaban | |||
| > 30 | 12 (11-13) | 24 h | 2 d |
| < 30 | Unknown | 2 d | 4 d |
| Calculated creatinine clearance, mL/min . | Half-life, hours . | Timing of last dose before surgery . | |
|---|---|---|---|
| Standard risk of bleeding* . | High risk of bleeding† . | ||
| Dabigatran | |||
| > 80 | 13 (11-22) | 24 h | 2 d |
| > 50- ≤ 80 | 15 (12-34) | 24 h | 2 d |
| > 30- ≤ 50 | 18 (13-23) | 2 d | 4 d |
| ≤ 30 | 27 (22-35) | 4 d | 6 d |
| Rivaroxaban | |||
| > 30 | 12 (11-13) | 24 h | 2 d |
| < 30 | Unknown | 2 d | 4 d |
Examples are cardiac catheterization, ablation therapy, colonoscopy without removal of large polyps, and uncomplicated laparoscopic procedures, such as cholecystectomy.
Examples are major cardiac surgery, insertion of pacemakers or defibrillators (resulting from the risk for pocket hematoma), neurosurgery, large hernia surgery, and major cancer/urologic/vascular surgery.