Consider It a Red Flag if You See a Direct Oral Anticoagulant Plus Warfarin

February 2019

Should warfarin ever be COMBINED with a direct oral anticoagulant (DOAC)...Eliquis (apixaban), Xarelto (rivaroxaban), etc?

Rarely. If short-term anticoagulant overlap is needed, an injectable (enoxaparin, etc) is almost always a better choice than a DOAC.

Explain DOACs can raise INR...making it hard to interpret warfarin's effect. Plus two oral anticoagulants is a recipe for mix-ups and harm.

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Table of Contents

Smoking Cessation Fine-Tune Smoking Cessation for Patients With Cardiovascular Disease
Gastroenterology Help Patients Take the First OTC Proton Pump Inhibitor Appropriately
Antibiotics Limit Quinolones Due to Aortic Aneurysm and Rupture Risks
Substance Use Disorder Don't Expect a Miracle With Meds for Alcohol Use Disorder
Cancer Weigh Risks Versus Benefits in Cancer Patients Needing an Anticoagulant
Ear, Nose & Throat Help Patients Manage Ringing in Their Ears
Nephrology Look for Patients Who May Need an ACEI or ARB After Acute Kidney Injury
Anticoagulants Consider It a Red Flag if You See a Direct Oral Anticoagulant Plus Warfarin
Adverse Events Help Clarify Concerns About Talc Products
Probiotics Educate Patients Not to Rely on Probiotics for Acute Diarrhea and Vomiting