Pharmacology · single question
A patient on apixaban needs an invasive dental procedure. How many days before the procedure should it be discontinued?
Show answer and explanation
Correct answer: B. 2 days
For most invasive dental procedures, apixaban should be discontinued 2 days (48 hours) before the procedure. This accounts for its half-life (~12 hours) and allows for adequate clearance. For high-bleed-risk procedures or patients with renal impairment, consultation with the prescribing physician is advisable. Apixaban can typically be restarted 24 hours after hemostasis is achieved.
- A. ❌ 1 day is insufficient for complete clearance of apixaban given its half-life of ~12 hours.
- B. ✅ CORRECT – Apixaban should be stopped 2 days before invasive dental procedures to allow adequate drug clearance.
- C. ❌ 5-day washout is used for warfarin (to allow vitamin K-dependent factor restoration), not apixaban.
- D. ❌ 7 days is excessive for apixaban discontinuation.