Suggestions for Peri-Procedural Management of Dabigatran

CrCl T 1/2

Time of last dose of dabigatran before procedure

(peri-procedural bridging is generally not required)

    Standard risk of bleeding

High risk of bleeding1
(major surgery, spinal puncture or placement of spinal/epidural catheter,
and other situations in which complete hemostasis may be required)

 

> 80 ml/min 14 hrs At least 24 hrs At least 48 hrs
50 – 79 ml/min 17 hrs At least 36 hrs At least 72 hrs
30-49 ml/min 19 hrs At least 48 hrs At least 96 hrs
15-29 ml/min 28 hrs at least 72 hrs at least 120 hrs
< 15 ml/min 34 hrs consider measuring drug activity with the dabigatran assay to determine absence of drug effect