![]() ![]() If possible, discontinue dabigatran 1 to 2 days (CrCl ≥50 mL/min) or 3 to 5 days (CrCl ![]() Converting to parenteral anticoagulant: Wait 12 hours (CrCl ≥30 mL/min) or 24 hours (CrCl CrCl CrCl 15-30 mL/min: Start warfarin 1 day before discontinuing dabigatran.CrCl 30-50 mL/min: Start warfarin 2 days before discontinuing dabigatran.CrCl ≥50 mL/min: Start warfarin 3 days before discontinuing dabigatran.Converting from parenteral anticoagulant: Give dabigatran 0-2 hours before time for next dose of the parenteral drug that was to have been administered or initiate at time of discontinuing continuous IV heparinĬonverting from dabigatran to warfarin or parenteral anticoagulants.Converting from warfarin: Discontinue warfarin and initiate dabigatran when INR Do not substitute different dosage forms (for example, capsules) for oral pellets on a milligram-to-milligram basis and do not combine more than 1 dosage form to achieve the total doseĬonverting to dabigatran from warfarin or parenteral anticoagulants.Additionally, there are differences between dosage forms with respect to dosing owing different bioavailability.Available in different dosage forms (ie, capsules for adults or children aged 8 to If dabigatran is not started on the day of surgery, after hemostasis has been achieved initiate treatment with 220 mg qDayĬrCl ≤30 mL/min or on dialysis: Dosing recommendations cannot be providedĬrCl <50 mL/min with concomitant use of P-gp inhibitors: Avoid coadministration Dosing Considerations Different dosage forms ![]() Prevention of stroke and systemic embolism associated with nonvalvular atrial fibrillationĬrCl ≤30 mL/min or on dialysis: Dosage recommendations cannot be providedĬrCl 30 mL/min: 110 mg PO 1-4 hr after surgery and after hemostasis has been achieved on first day, then 220 mg taken qDay for 28-35 days Stroke Prophylaxis With Atrial Fibrillation ![]()
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