All Patients | All Patients | Warfarin | Rivaroxaban | Apixaban | Edoxaban | Dabigatran |
Day 1-2: Nursing or Anticoagulation Clinic – phone call to patient | Ensure patient has obtained prescription Assess for bleeding complications, recurrent/progressive thrombotic symptoms Ensure dosing is appropriate for renal function (checked at time of DVT diagnosis) | Ensure patient is taking warfarin at dose prescribed | Ensure patient is on 15 mg twice daily and taking with food | Ensure patient is taking 10 mg twice daily | | |
Day 5: Nursing or Anticoagulation Clinic follow up | Assess medication compliance, bleeding complications, recurrent/progressive thrombotic symptoms, scheduled procedures, concomitant medications | Check INR, when between 2 and 3 discontinue LMWH or fondaparinux | | Ensure dose change after day 7 from 10 mg twice daily to 5 mg twice daily | Switch from LMWH to Edoxaban | Switch from LMWH to Dabigatran |
Day 21: Nursing or Anticoagulation Clinic- phone call to patient | Assess medication compliance, bleeding complications, recurrent/progressive thrombotic symptoms, scheduled procedures, concomitant medications | | Ensure dose change after day 21 from 15 mg twice daily to 20 mg/day | | | |
3 months Clinic visit | Assess medication compliance, bleeding complications, recurrent/progressive thrombotic symptoms, scheduled procedures, concomitant medications Reassess length of treatment (3 months vs. extended or indefinite) Patients with Cockcroft-Gault (CrCl 30 -50 mL/min, repeat renal function testing | | | | | |
6 months: Nursing or Anticoagulation Clinic follow up Assess risk factors for the need to continue (extended duration or (indefinite) anticoagulation | Assess medication compliance, bleeding complications, recurrent/progressive thrombotic symptoms, scheduled procedures, concomitant medications Patients with Cockcroft-Gault (CrCl 30 -50 mL/min, repeat renal function testing | | Assess for extended duration dosage of 10 mg daily | Assess for extended duration dosage of 2.5 mg twice daily | | Assess for extended duration dosage of 150 mg twice daily |
9 months: Nursing or Anticoagulation Clinic follow up | Assess medication compliance, bleeding complications, recurrent/progressive thrombotic symptoms, scheduled procedures, concomitant medications Patients with Cockcroft-Gault (CrCl 30 -50 mL/min, repeat renal function testing | | | | | |
1 year: Clinic visit | compliance, bleeding complications, recurrent/progressive thrombotic symptoms, scheduled procedures, concomitant medications Patients with Cockcroft-Gault (CrCl 30 -50 mL/min, repeat renal function testing | | | | | |