Roche CoaguChek XS Plus, Training Manual

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62 CoaguChek Professional Monitoring Systems
Training Manual
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For stroke prevention in atrial fibrillation, patients who would be considered for warfarin should be
considered for rivaroxaban
Dose
10 mg once daily dose – fixed
Starting Rivaroxaban
Initial dose should be taken 6 – 10 hours after surgery and for major hip surgery 5 weeks treatment
recommended.
Major knee surgery 2 weeks is recommended
There is no need to give LMWH
Apixaban is another factor Xa inhibitor also taken orally and is licensed for thromboprophylaxis for
knee and hip surgery and also for non-valvular atrial fibrillation.
Dose
2.5mg taken twice a day
There is no need to give LMWH
For stroke prevention in atrial fibrillation, patients who would be considered for warfarin should be
considered for apixaban
Procedure before starting novel anticoagulants
Check :
1. Renal function - egfr
2. INR, PT, APPT
3. Liver function tests
4. Review concomitant meds – interactions verapamil
The patient can be switched from warfarin when INR is 2.0 or below
See Appendix 3 for suggested care pathway