Table 3 Pre- and post-operative care for patients on NOACs [28]
From: NOACs: an emerging class of oral anticoagulants-a review article
Drug | Minor surgical procedure | Major surgical procedure | |||
|---|---|---|---|---|---|
Renal function(based on creatinine clearance) | Pre-operative care | Post-operative care | Pre-operative care | Post-operative care | |
Dabigatran | Normal function or mild impairment with creatinine clearance greater than 50 ml/min | Withhold therapy for 2 days prior to surgery (i.e. omit 2 doses) | Resume 24 h following surgery | Withhold therapy for 3 days prior to surgery (i.e. omit 4 doses) | Resume 48 h following surgery |
Moderate impairment with creatinine clearance between 30-50 ml/min | Withhold therapy for 3 days prior to surgery (i.e. omit 4 doses) | Resume 24 h following surgery | Withhold therapy for 4-5 days prior to surgery (i.e. omit 6-8 doses) | Resume 48 h following surgery | |
Rivaroxaban | Normal, mild, or moderate impairment with creatinine clearance greater than 30 ml/min | Withhold therapy for 2 days prior to surgery (i.e. omit 1 dose) | Resume 24 h following surgery | Withhold 3 days prior to surgery (i.e. omit 2 doses) | Resume 48 h following surgery |
Edoxaban | Normal, mild, or moderate impairment with creatinine clearance greater than 30 ml/min | Withhold therapy for 2 days prior to surgery (i.e. omit 1 dose) | Resume 24 h following surgery | Withhold 3 days prior to surgery (i.e. omit 4 doses) | Resume 48 h following surgery |
Apixaban | Normal, mild, or moderate impairment with creatinine clearance greater than 30 ml/min | Withhold therapy for 2 days prior to surgery (i.e. omit 1 dose) | Resume 24 h following surgery | Withhold 3 days prior to surgery (i.e. omit 4 doses) | Resume 48 h following surgery |