Restarting Apixaban After Stable Hemoperitoneum

Initial Management – Discontinuation of Anticoagulation

Required Conditions Before Restarting Anticoagulation

Contraindications That Delay Restart

Timing of Restart

Restart Protocol

Step 1 – Confirm Stability (24–48 hours Post‑Bleed)

Step 2 – Assess Thrombotic Risk and Determine Timing

Step 3 – Resume Apixaban at the Patient’s Maintenance Dose

Common Pitfalls to Avoid

Special Considerations

When Anticoagulation Cannot Be Restarted

Management of Concomitant Antiplatelet Therapy