What is the preferred washout time for a patient with normal or impaired renal function taking Eliquis (apixaban) before undergoing heart catheterization?

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Eliquis (Apixaban) Washout Time Before Heart Catheterization

For elective heart catheterization, hold apixaban for 24 hours (skip 2 doses) if using transradial access with normal renal function (CrCl ≥30 mL/min), or 48 hours (skip 4 doses) if using transfemoral access. 1

Transradial Approach (Preferred Access)

Normal Renal Function (CrCl ≥30 mL/min):

  • Hold apixaban for ≥24 hours before procedure 1
  • This corresponds to skipping 2 doses 1
  • Last dose should be taken the morning of the day before the procedure 1

Impaired Renal Function (CrCl 15-29 mL/min):

  • Hold apixaban for ≥36 hours before procedure 1
  • Longer washout needed due to reduced renal clearance (27% of apixaban is renally cleared) 2

Severe Renal Impairment (CrCl <15 mL/min):

  • Hold for ≥48 hours or guide duration by agent-specific anti-Xa level 1

Transfemoral Approach

Normal Renal Function (CrCl ≥30 mL/min):

  • Hold apixaban for ≥48 hours before procedure 1
  • This corresponds to skipping 4 doses 1
  • Longer washout required due to higher bleeding risk with femoral access 1

Impaired Renal Function (CrCl <29 mL/min):

  • Hold for ≥72 hours or guide duration by agent-specific anti-Xa level 1

Key Clinical Considerations

Apixaban Pharmacokinetics:

  • Half-life is 12 hours (range 10-15 hours) 1
  • The 24-48 hour washout period allows for 2-4 half-lives to elapse, achieving minimal residual anticoagulant effect 1
  • Real-world data confirms that 48+ hours of discontinuation results in clinically insignificant anticoagulation (94% of patients achieved levels ≤30 ng/mL) 3

No Bridging Required:

  • Do not bridge with parenteral anticoagulation (LMWH or heparin) during the washout period 1
  • The predictable short half-life of apixaban makes bridging unnecessary and increases bleeding risk 1
  • Bridging is only considered for patients presenting with acute coronary syndrome, not stable elective cases 1

Emergency Situations:

  • For STEMI or high-risk NSTEMI, stop apixaban immediately and proceed with PCI without delay 1
  • Activated clotting time (ACT) is not a reliable indicator of apixaban anticoagulation during emergency procedures 1
  • Consider reversal with andexanet alfa for life-threatening bleeding 4

Common Pitfalls to Avoid

Drug Interactions:

  • Patients taking concomitant P-gp inhibitors (dronedarone, amiodarone, verapamil) may need an additional 24 hours of washout 1
  • These medications prolong apixaban clearance and increase bleeding risk 1

Renal Function Assessment:

  • Always calculate creatinine clearance before determining washout duration 1, 2
  • Moderate renal impairment significantly prolongs apixaban elimination 2
  • Do not rely on serum creatinine alone 1

Timing Errors:

  • The FDA label states apixaban should be discontinued at least 48 hours prior to elective surgery with moderate-to-high bleeding risk 5
  • However, the 2021 ACC guidelines provide more nuanced, access-specific recommendations that allow for 24-hour washout with radial access 1
  • Use the access-specific approach from the most recent ACC guidelines rather than the blanket FDA recommendation 1

Unreliable Laboratory Monitoring:

  • Do not use INR or aPTT to guide timing, as apixaban's effect on these tests is inconsistent 2
  • If measurement is needed, use agent-specific anti-Xa levels 1

Postprocedural Resumption

  • Resume apixaban ≥24 hours after low bleeding risk procedures once adequate hemostasis is established 1, 5
  • For high bleeding risk procedures or complications, consider resuming at 48-72 hours postprocedure 1
  • No loading dose is required due to rapid onset of action 1

Algorithm Summary

  1. Assess renal function (calculate CrCl) 1, 2
  2. Determine access site (radial vs femoral) 1
  3. Check for drug interactions (P-gp inhibitors) 1
  4. Apply washout period:
    • Radial + normal renal function = 24 hours 1
    • Femoral + normal renal function = 48 hours 1
    • Adjust upward for renal impairment 1
  5. Do not bridge with parenteral anticoagulation 1
  6. Resume ≥24 hours post-procedure with adequate hemostasis 1, 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Apixaban Preoperative Discontinuation Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

A new strategy for uncontrollable bleeding after treatment with rivaroxaban or apixaban.

Clinical advances in hematology & oncology : H&O, 2019

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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