Taking a DOAC Blood Thinner: Your Daily Safety Guide
Pharmacology · High-Alert Medications
Apixaban, rivaroxaban, dabigatran, and edoxaban are blood thinners. They help prevent clots and stroke. They also make bleeding harder to stop.
Take it on time
- Take it at the same times every day.
- Apixaban and dabigatran: twice a day, about 12 hours apart.
- Rivaroxaban 15 mg or 20 mg: take it with food. For an uneven heartbeat (AF), take it with your evening meal.
- Swallow dabigatran capsules whole. Keep them in the original bottle.
- Your medicine and times: ____________.
If you miss a dose
- Take it when you remember that same day.
- Never take a double dose. Ask your pharmacist if you are not sure.
- Never stop it on your own. Stopping raises your stroke risk.
Keep your checkups
- You do not need regular INR blood tests.
- You need a kidney blood test at least once a year.
Prevent bleeding
- Use a soft toothbrush and an electric razor.
- Do not take ibuprofen (Advil, Motrin), naproxen (Aleve), or aspirin unless your provider approves.
- Ask your pharmacist before any new medicine or herb.
Tell every provider
- Tell every provider and dentist. Carry a card or wear a medical alert ID.
- Before surgery or dental work, ask when to stop and restart.
- Get emergency care after any head injury, even if you feel well.
Call your provider today if you have
- New bruising, small nosebleeds, or bleeding gums
- Pink or red urine, or heavier periods: call promptly
- A missed dose, a new medicine, or a possible pregnancy
Call 911 or your local emergency number if you have
- Bleeding that will not stop
- Vomiting blood, or black, sticky stool
- A head injury or a sudden, severe headache
- Loss of balance, vision change, face droop, arm weakness, or trouble speaking