Eliquis Management Before Dental Procedures

Risk Stratification and Procedure-Related Considerations

• Low-risk dental procedures, such as routine cleanings and simple restorations, can be managed with Eliquis interruption for 24 hours before the procedure, according to Praxis Medical Insights 1
• High-risk procedures, including multiple extractions and surgical extractions, require Eliquis interruption for 48 hours before the procedure, as recommended by Anaesthesia guidelines 2, 3, 4

Special Considerations Based on Renal Function

• For patients with creatinine clearance >30 mL/min, the standard 2-3 day interruption applies for high-risk procedures, as stated by Anaesthesia guidelines 2, 3, 4
• The French perioperative guidelines recommend stopping apixaban 3 days before high hemorrhagic risk procedures when CrCl >30 mL/min, as published in Anaesthesia 2, 3, 4

Critical Pitfalls to Avoid

• Never use bridging anticoagulation with heparin products when stopping Eliquis for dental procedures, as this dramatically increases bleeding risk without reducing thrombotic risk, according to Praxis Medical Insights 1
• Do not perform neuraxial blocks or deep nerve blocks if there is any possibility of residual Eliquis levels, particularly in elderly patients or those with renal impairment, as warned by Anaesthesia guidelines 2, 3

Resumption After the Procedure

• Resume Eliquis at least 6 hours after the procedure if hemostasis is adequate and there is no ongoing bleeding, as recommended by Praxis Medical Insights 1
• For twice-daily dosing, resume the evening of the procedure day, according to Anaesthesia guidelines 3, 4, 5