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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