Understanding the Necessity of Bridging Therapy with Eliquis- Is It a Must-

Does Eliquis Require Bridging?

Eliquis, also known as apixaban, is a popular anticoagulant medication used to prevent blood clots in patients with atrial fibrillation (AF), deep vein thrombosis (DVT), and pulmonary embolism (PE). As with any anticoagulant, there is often a concern about the need for bridging therapy when a patient is undergoing surgery or has a high risk of thromboembolic events. This article aims to explore whether Eliquis requires bridging therapy and the considerations involved in this decision.

Bridging therapy is a temporary interruption in anticoagulation therapy, usually administered when a patient is at an increased risk of thromboembolic events, such as during surgery or when there is a risk of bleeding. The purpose of bridging therapy is to reduce the risk of thromboembolism while minimizing the risk of bleeding complications.

In the case of Eliquis, it is generally not recommended to discontinue the medication and initiate bridging therapy. This is due to the fact that Eliquis has a short half-life, which means it is quickly eliminated from the body. As a result, stopping Eliquis can lead to a rapid reversal of its anticoagulant effects, increasing the risk of thromboembolic events.

However, there are certain situations where bridging therapy may be considered for Eliquis. These include:

1. Major surgery: In patients undergoing major surgery, bridging therapy may be considered to reduce the risk of thromboembolism during the perioperative period. The decision to bridge should be made on a case-by-case basis, taking into account the patient’s risk of thromboembolism and bleeding.

2. Urgent surgery: If a patient is scheduled for urgent surgery and there is insufficient time to wait for the anticoagulant effects of Eliquis to diminish, bridging therapy may be necessary. In such cases, a low molecular weight heparin (LMWH) may be used for bridging.

3. High-risk patients: Patients with a high risk of thromboembolism, such as those with a history of recurrent DVT or PE, may benefit from bridging therapy during certain procedures, such as dental work or endoscopy.

It is important to note that the decision to bridge Eliquis should be made in collaboration with the patient’s healthcare provider. Factors to consider include the patient’s overall risk of thromboembolism and bleeding, the nature of the surgery or procedure, and the duration of the procedure.

In conclusion, Eliquis generally does not require bridging therapy due to its short half-life. However, in certain situations, such as major surgery or for high-risk patients, bridging therapy may be considered. The decision to bridge Eliquis should be made on a case-by-case basis, with careful consideration of the patient’s individual risk factors and the nature of the procedure.