For most routine dental extractions, how should apixaban be managed?

Correct answer: C. It is generally NOT interrupted; if the physician requires interruption for a high-bleeding-risk procedure, it is typically held about 48 hours

• A. Bridging a DOAC with warfarin is not a recognized practice and would be far more complex and risky.
• B. Seven days is far longer than any DOAC requires and creates unacceptable thromboembolic exposure.
• C. CORRECT. Current guidance for DOACs (apixaban, rivaroxaban, dabigatran, edoxaban) is that most routine dental procedures — including simple extractions of one to three teeth — should proceed WITHOUT interrupting the drug, relying on local hemostatic measures. Where a physician determines interruption is warranted for a genuinely high-bleeding-risk procedure, apixaban is typically held for about 24–48 hours given its short half-life (roughly 12 hours) and rapid offset, with renal function taken into account.
• D. Fourteen days is grossly excessive.

Note: ⚠️ Any interruption is the PHYSICIAN's decision, not the dentist's. Consider timing the appointment for the morning, early in the week, and before the next dose is due.