Postoperative resumption of new oral anticoagulants: a suggested management approach
| Drug . | Low bleeding risk surgery . | High bleeding risk surgery . |
|---|---|---|
| Dabigatran | Resume on day after surgery (24 h postoperative), 150 mg twice daily | Resume 2-3 days after surgery (48-72 h postoperative), 150 mg twice daily* |
| Rivaroxaban | Resume on day after surgery (24 h postoperative), 20 mg once daily | Resume 2-3 days after surgery (48-72 h postoperative), 20 mg once daily† |
| Apixaban | Resume on day after surgery (24 h postoperative), 5 mg twice daily | Resume 2-3 days after surgery (48-72 h postoperative), 5 mg twice daily† |
| Drug . | Low bleeding risk surgery . | High bleeding risk surgery . |
|---|---|---|
| Dabigatran | Resume on day after surgery (24 h postoperative), 150 mg twice daily | Resume 2-3 days after surgery (48-72 h postoperative), 150 mg twice daily* |
| Rivaroxaban | Resume on day after surgery (24 h postoperative), 20 mg once daily | Resume 2-3 days after surgery (48-72 h postoperative), 20 mg once daily† |
| Apixaban | Resume on day after surgery (24 h postoperative), 5 mg twice daily | Resume 2-3 days after surgery (48-72 h postoperative), 5 mg twice daily† |
For patients at high risk for thromboembolism, consider administering a reduced dose of dabigatran (eg, 110-150 mg once daily) on the evening after surgery and on the following day (first postoperative day) after surgery.
Consider a reduced dose (ie, rivaroxaban 10 mg once a day or apixaban 2.5 mg twice a day) in patients at high risk for thromboembolism.