Discontinuation rules for dabigatran before invasive or surgical procedure8 14 15
| Stop dabigatran before elective surgery | |||
|---|---|---|---|
| Renal function (CrCl (ml/min)) | Estimated half-life(h) | Major surgery or high bleeding risk* | Non-major surgery or standard risk† |
| >80 | ∼13 | 48 h before | 24 h before |
| >50 and <80 | ∼15 | 48–72 h before | 24–48 h before |
| >30 and <50 | ∼18 | 96 h before | 48–72 h before |
*Examples of major surgery/high bleeding risk: cardiothoracic surgery, neurosurgery, major abdominal or pelvic surgery, major orthopaedic surgery, insertion of cardiac pacemaker/defibrillator.
†Examples of non-major surgery/standard risk: uncomplicated laparoscopic procedure, cardiac catheterisation/ablation therapy.
CrCl, creatinine clearance.