Do I need to bridge patients with heparin or LMWH to XARELTO®?

There is no need to bridge with heparin or LMWH for the DVT and PE treatment indications. XARELTO® can be used as a single, oral agent at the time of diagnosis; it can also be used following initial treatment with heparin or LMWH.1,2

Initiation of XARELTO® is not recommended acutely as an alternative to unfractionated heparin in patients with PE who present with hemodynamic instability or who may receive thrombolysis or pulmonary embolectomy.

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◇For VTE prophylaxis in acutely ill medical patients at risk for thromboembolic complications who are not at high risk of bleeding.

DVT = deep vein thrombosis; LMWH = low-molecular-weight heparin; PE = pulmonary embolism.