An anticoagulation option for nonvalvular atrial fibrillation
The Journal of Family Practice. 2012 June;61(6):E1-E6
June 1, 2012|The Journal of Family Practice
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Patients with a risk of stroke—particularly those taking warfarin with poorly controlled INR—may be candidates for dabigatran.
TABLE 3
Recommendations for withholding dabigatran before elective surgery29
| Renal function (creatinine clearance), mL/min | Estimated half-life (range), h | Discontinue dabigatran before surgery | |
|---|---|---|---|
| High risk of bleeding* | Standard risk | ||
| >50-80 | ~15 (12-17) | 2-3 days before | 24 hours before (2 doses) |
| 30-50 | ~18 (18-24) | 4 days before | At least 2 days (48 hours) before |
| <30 | ~27 (>24) | >5 days before | 2-5 days before |
| *Surgeries that confer a high risk of bleeding include, but are not limited to, cardiac surgery, neurosurgery, abdominal surgery, or procedures involving a major organ. Procedures involving spinal anesthesia or spinal tap may also be considered as having a high risk of bleeding | |||
CORRESPONDENCE Rajesh Kabra, MD, University of Tennessee Health Sciences Center, 1325 Eastmoreland Avenue, Suite 460, Memphis, TN 38104; rkabra@uthsc.edu
