Converting to/from Edoxaban

CONVERSION UW MEDICINERECOMMENDATION
From warfarin to edoxaban

Stop warfarin and start edoxaban with INR < lower limit of therapeutic range

(manufacturer recommends when INR < 2.5)

From edoxaban to warfarin

 

NOTE: edoxaban is not intended to be used as a short term “bridge to warfarin.  These recommendations refer to transitioning patients who are taking edoxaban on a long term basis and are switching to warfarin instead

Start warfarin and stop edoxaban 3 days later

Manufacturer recommends

a) for patients taking 60mg, reduce edoxaban to 30mg and start warfarin concomitantly.  Stop edoxaban when INR > 2

b)for patients taking 30mg, reduce edoxaban to 15mg and start warfarin concomitantly.  Stop edoxaban when INR > 2

OR if continuous , uninterrupted anticoagulation is necessary

a) stop edoxaban

b) begin both a parenteral anticoagulant (LMWH/fondaparinux or UFH) and warfarin at the same time that the next dose of edoxaban would have been givenc) stop the parenteral anticoagulant when the INR is > 2

From LMWH/Fondaparinux to edoxaban Stop LMWH/Fondaparinux and start edoxaban at the same time that the next dose of LMWH/fondaparinux would have been given
From IV heparin to edoxaban

Stop IV heparin and start edoxaban simultaneously

(manufacturer recommends starting edoxaban 4 hrs after stopping IV heparin)

From edoxaban to parenteral anticoagulant Stop edoxaban and start the parenteral anticoagulant at the same time that the next dose of edoxaban would have been given

From Edoxaban to apixaban, dabigatran or rivaroxaban

Stop edoxaban and start the other anticoagulant at the same time that the next scheduled dose of edoxaban would have been given