184.108.40.206 Prophylaxis of venous thromboembolism in orthopaedics-specialist use in secondary care only
For specialist use in secondary care only.
For further information, refer to NICE NG89 Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism .
|1st choice oral anticoagulant for VTE in orthopaedic surgery||Apixaban tablets 2.5mg|
|2nd choices||Dabigatran capsules 75mg, 110mg|
|Rivaroxaban tablets 10mg|
- Abixaban, dabigatran and rivaroxaban are approved for specialist use only, in hip and knee replacement surgery, for prophylaxis of venous thromboembolism.
- NICE have issued a number of pieces of guidance in relation to the newer oral anticoagulants and the prophylaxis of venous thromboembolism-listed below for information:
- NICE TA 157 (September 2008) Dabigatran etexilate for the prevention of venous thromboembolism after hip or knee surgery in adults
- NICE TA 170 (April 2009) Rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults
- NICE TA 245 (January 2012) Apixaban for the prevention of venous thromboembolism after total hip or knee replacements in adults
- Dabigatran capsules cannot be crushed or opened and cannot be used in standard compliance aids due to the instability of the drug.
- Refer to BNF for full details of cautions, contraindications and interactions with DOACs.