Enoxaparin : 40mg once daily : 40mg twice daily: 1
The generalizability of these findings, while limited by the few sites surveyed and the low response rate at the secondary Click here for ‘DOAC bridging’ protocol Warfarin CrCl ≥ 50mL/min – warfarin should be started 3 days before stopping dabigatran CrCl 30-50mL/min – warfarin should be started 2 days before stopping dabigatran
Due to an initial prothrombotic state and a delayed onset of anticoagulation, warfarin is commonly “bridged” with parenteral anticoagulants until Enoxaparin (Lovenox) Lovenox Discontinuation Plan In patients who are receiving bridge Last preoperative dose approximately 24 hours before surgery Lovenox Resumption 24 hours in patients undergoing low-risk bleeding 48-72 hours in patient undergoing high-bleeding risk surgery IV Unfractionated Heparin (UFH) IV UFH Discontinuation Plan INTRODUCTION
Many times patients will be transitioned (or bridged) to Coumadin from Lovenox
You will also learn where on your body to insert the The investigators began bridging with enoxaparin 1 mg/kg twice daily
(enoxaparin, fondaparinux, dalteparin) Stop dabigatran CrCl ≥ 30 mL/min – start agent 12 hours after last dose of dabigatran Begin parenteral anticoagulant (bridge therapy) and warfarin at the time the next dose of edoxaban is due
) The Bridging Anticoagulation in Patients who Require Temporary Interruption of Warfarin Therapy for an Elective Invasive Procedure or Surgery trial (BRIDGE study) was a landmark study that explored the safety and efficacy of bridging LMWH use for patients on chronic warfarin therapy for stroke prevention in non-valvular atrial fibrillation
5mg/kg/day or 1mg/kg/bid
Both hospital based physicians and primary physicians need to know how to start Warfarin treatment for their patients
Bridging
Antiplatelet therapy was used in 67
A future Point-of-Care Guide will address evidence-based guidelines for adjustments to the warfarin dosage in patients on long-term therapy