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Table 6: Time frame between last dose of Direct Oral Anticoagulants (DOACs) and procedures with high bleeding risk 

CrCl (ml/min) Apixaban, Edoxaban & Rivaroxaban Dabigatran
≥80ml/min 

Take the last dose 3 days before the procedure 

(e.g. Procedure on Wednesday, take the last dose on Sunday)

Take the last dose 3 days before the procedure 

(e.g. Procedure on Wednesday, take the last dose on Sunday) 
50-80ml/min 

Take the last dose 3 days before the procedure 

(e.g. Procedure on Wednesday, take the last dose on Sunday)

Take the last dose 4 days before the procedure 

(e.g. Procedure on Wednesday, take the last dose on Saturday)
30-50ml/min 

Take the last dose 3 days before the procedure 

(e.g. Procedure on Wednesday, take the last dose on Sunday)

Take the last dose 5 days before the procedure 

(e.g. Procedure on Wednesday, take the last dose on Friday)
15-30ml/min 

Take the last dose 4 days before the procedure 

(e.g. Procedure on Wednesday, take the last dose on Saturday)

 Contraindicated 
<15ml/min Contraindicated 

Notes

  1. Factor Xa inhibitor drugs (apixaban, edoxaban and rivaroxaban) should be omitted for the timeframes above aiming for a normal prothrombin time (PT).  Note: A normal PT does not exclude the possibility of therapeutic anticoagulant levels. 
  2. Patients undergoing elective colonoscopy under bowel screening programme: 
    1. For patients on apixaban, edoxaban or rivaroxaban, there is no requirement to check renal function in line with table 6 above.  Taking the last dose 3 days prior to the endoscopy is sufficient and in line with British Society of Gastroenterology guidelines.
    2. Patients on dabigatran require an up to date calculation of renal function and the recommendations in table 6 followed as dabigatran is more affected by changes in renal function. 

Guideline reviewed: August 2025

Page updated: July 2026