Ask Mac – Questions ListCategory: AnalgesiaHow long should a patient be off anti-coagulant therapy before it is safe to administer NSAIDS?
asked 3 years ago
This question came to me via a self report so I thought it was a good one to put here.   The situation was: Patient was released from hospital less than 1 week ago and while in hospital they were on heparin.  They were no longer on heparin at this time.   When would it be safe to administer NSAID's again to this patient?  The medic wasn't sure so they withheld NSAID's.
1 Answers
answered 2 years ago
To answer the question on when NSAIDS would be contraindicated for patients taking anticoagulants it is important to understand the timeframe that these medication remain active. The effects of IV heparin will only last a few hours once discontinued, while low molecular weight heparin or novel anticoagulants (rivaroxaban, dabigatran, apixaban) will normally take about 24 hours to become ineffective.  The longest acting anticoagulant would be warfarin (Coumadin) and effects would last for 4-5 days.  To keep things simple, I would consider withholding NSAIDs only if a patient is actively taking an anticoagulant as part of their regular medications. 
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