Anti-coagulation PRINT
| MEDICATION | PROCEDURE | |||||||
|---|---|---|---|---|---|---|---|---|
| Thoracentesis, Paracentesis, Joint Injection, Vena Cava Filter Removal | Superficial biopsies, abscess drain, chest tubes, Ports, PEG tube | Lung, Liver, Kidney biopsy or ablation | Lumbar Drains, Lumbar Puncture, Myelogram | Epidurals, Facet Blocks, Selective Nerve Root Blocks | Vertebro-plasty, Kypho-plasty | Angiograms, Stent Placement, Dialysis Graft or Fistula | ||
| Acetyl Sialic Acid (Aspirin) | Continue | Continue | Off 5 days | Continue | Continue | Continue | Continue | |
| Apixaban (Eliquis) | Continue | Hold 24 hours pre and 24 hours post | Hold 24 hours pre and 24 hours post | Hold 24 hours pre and 24 hours post | Hold 24 hours pre and 24 hours post | Hold 24 hours pre and 24 hours post | Hold 24 hours pre and 24 hours post | |
| Cilostazol (Pletal) | Continue | Off 3 days, if possible. | Off 5 days | Off 5 days | Off 5 days | Off 5 days | Continue | |
| Clopidogrel (Plavix) | Continue | Off 3 days, if possible. | Off 5 days | Off 5 days | Off 5 days | Off 5 days | Continue | |
| Dabigatran (Pradaxa) | Continue | Off 3 days, if possible. INR < 1.5 | Off 3 days, if possible. INR < 1.5 | Off 3 days, if possible. INR < 1.5 | Off 3 days, if possible. INR < 1.5 | Off 3 days | Off 3 days, if possible | |
| Dalteparin (Fragmin) | Continue | Hold 24 hours pre and 24 hours post | Hold 24 hours pre and 24 hours post | Hold 24 hours pre and 24 hours post | Hold 24 hours pre and 24 hours post | Hold 24 hours pre and 24 hours post | Hold 24 hours pre and 24 hours post | |
| Dipyridamole + Acetyl Sialic Acid (Aggrenox) | Continue | Continue | Off 5 days | Continue | Continue | Continue | Continue | |
| Enoxaparin (Lovenox), prophylactic @ 30-40 mg daily | Continue | Continue | Hold 12 hours pre and post | Hold 12 hours pre and 24 hours post | Continue | Continue | Continue | |
| Enoxaparin (Lovenox), therapeutic @ 1 mg / kg BID | Continue | Hold 12 hours pre and post | Hold 12 hours pre and post | Hold 24 hours pre and post | Hold 12 hours pre and post | Hold 12 hours pre and post | Hold 12 hours pre and post | |
| Fondaparinux (Arixtra) | Continue | Hold 24 hours pre and 24 hours post | Hold 24 hours pre and 24 hours post | Hold 24 hours pre and 24 hours post | Hold 24 hours pre and 24 hours post | Hold 24 hours pre and 24 hours post | Hold 24 hours pre and 24 hours post | |
| Heparin, IV | Continue | Hold 12 hours pre and post | Hold 12 hours pre and post | Hold 24 hours pre and post | Hold 12 hours pre and post | Hold 12 hours pre and post | Hold 12 hours pre and post | |
| Heparin, subcutaneous, prophylactic 5000U BID-TID | Continue | Continue | Hold 12 hours pre and post | Hold 12 hours pre and 24 hours post | Continue | Continue | Continue | |
| Non-Steroidal Anti-Inflammatory | Continue | Continue | Continue | Continue | Continue | Continue | Continue | |
| Prasugel (Effient) | Continue | Off 3 days, if possible. | Off 5 days | Off 5 days | Off 5 days | Off 5 days | Continue | |
| Rivaroxiban (Xarelto) | Continue | Hold 24 hours pre and 24 hours post | Hold 24 hours pre and 24 hours post | Hold 24 hours pre and 24 hours post | Hold 24 hours pre and 24 hours post | Hold 24 hours pre and 24 hours post | Hold 24 hours pre and 24 hours post | |
| Ticagrelor (Brilinta) | Continue | Off 3 days, if possible. | Off 5 days | Off 5 days | Off 5 days | Off 5 days | Continue | |
| Ticlopidine (Ticlid) | Continue | Off 3 days, if possible. | Off 5 days | Off 5 days | Off 5 days | Off 5 days | Continue | |
| Warfarin (Coumadin) | Continue | Off 3 days, if possible. INR < 1.5 | Off 3 days, if possible. INR < 1.5 | Off 3 days, if possible. INR < 1.5 | Off 3 days, if possible. INR < 1.5 | Off 3 days | Off 3 days, if possible | |
Pradaxa (Dabigatron) Direct Thrombin Inhibitor, Anticoagulant; Elimination Half Life: 12-17 hours. Renal impairment: 15-34.1 hours.
Coumadin (Warfarin) Anticoagulant Elimination Half Life: 1 week. New reversal agent: Kcentra – FDA approved 4/13. Faster than FFP, Less volume, no blood typing req’d. Can use with vit K. Check w/ hosp to see if available.
Xarelto (Rivaroxaban) Factor Xa Inhibitor, Anticoagulant. Elimination Half Life: 5 to 9 hours. Elderly 11 to 19 hours. Renal Impairment 8.7 to 9.5 hours. NO REVERSAL AGENT
Lovenox (Enoxaparin) Low Molecular Weight Heparin, Anticoagulant. Elimination Half-Life: 7 hours.
Fragmin (Dalteparin) Low Molecular Weight Heparin, Anticoagulant. Elimination Half Life: Sub Q: 3 to 5 hours. IV: 2.1 to 2.3 hours. Chronic Renal Insufficiency: 5.7 +/- 2 hours.
Arixtra (Fondaparinux) Factor Xa Inhibitor, Anticoagulant. Elimination Half-Life: 17 to 21 hours. Renal Impairment: prolonged. Elderly: prolonged. NO REVERSAL AGENT, but some may dialyze off.
Plavix (Clopidogrel) ADP-Induced Aggregation Inhibitor, Platelet Aggregation Inhibitor. Elimination Half Life: 6 hours (Clopidogrel). 0.5-0.7 hours (Thiol deriative).
Effient (Prasugrel) ADP-Induced Aggregation Inhibitor, Platelet Aggregation Inhibitor. Elimination Half Life: Adults: 7-8 hours (range 2 to 15 hours).
Brilinta (Tigrelor) ADP-Induced Aggregation Inhibitor, Platelet Aggregation Inhibitor. Elimination Half Life: 7 hours.
Ticlid (Ticlodipine) ADP-Induced Aggregation Inhibitor, Platelet Aggregation Inhibitor. Elimination Half-Life: 4-5 days.
Aggrenox (Aspirin/Dipyridamole) Platelet Aggregation Inhibitor, Phosodiesterase Inhibitor. Elimination Half Life Aspirin 0.3 hours. Dipyridamole extended-release: about 14 hours. Salicyclic acid: 1.71 hours.
Eliquis (Apixaban) Factor Xa inhibitor. Indicated for a-fib Elimination Half life: 6-12 hours. Prolongs PTT, PT, INR, but not predictably. NO REVERSAL AGENT