Suggestions for Conversion To/From Apixaban
| CONVERSION | UW MEDICINE RECOMMENDATION |
| from warfarin to apixaban | stop warfarin and start apixaban when INR < lower limit of therapeutic range |
|
from apixaban to warfarin
(NOTE: apixaban is not intended to be used as a short term "bridge" to warfarin. These recommendations refer to transitioning patients who are taking apixaban on a long term basis and are switching to warfarin instead)
|
start warfarin and stop apixaban 3 days later OR IF continuous, uninterrupted anticoagulation is necessary: a) Stop apixaban b) Begin both a parenteral anticoagulant (LMWH/fondaparinux or UFH) and warfarin at the same time that the next dose of apixaban would have been given c) Stop the parenteral anticoagulant when INR is > lower limit of therapeutic range |
| from LMWH/fondaparinux to apixaban | stop LMWH/fondaparinux and start apixaban at the same time that the next dose of LMWH/fondaparinux would have been given |
| from IV heparin to apixaban | Stop IV heparin and start apixaban simultaneously |
| from apixaban to parenteral anticoagulant | stop apixaban and administer first dose of parenteral anticoagulant at the time that the next dose of apixaban would have been given |
| from apixaban to dabigatran, edoxaban, or rivaroxaban | stop apixaban and begin the other agent at the time that the next scheduled dose of apixaban would have been given |
