2.8.2.2 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 .

ChoiceDrugDosage
1st choices oral anticoagulant for VTE in orthopaedic surgeryApixaban▼ tablets 2.5mgDose:
Prophylaxis of venous thromboembolism following knee replacement surgery – 2.5mg twice daily for 10-14 days, starting 12-24 hours after surgery

Prophylaxis of venous thromboembolism following hip replacement surgery, 2.5mg twice daily for 32-38 days, starting 12-24 hours after surgery
Or
Dabigatran capsules
75mg, 110mg

Dose:
Prophylaxis of venous thromboembolism following total hip replacement surgery - 110mg (ELDERLY over 75 years, 75mg) 1-4 hours after surgery, followed by 220mg (ELDERLY over 75 years, 150mg) once daily for 28-35 days, to be taken on the first day after surgery

Prophylaxis of venous thromboembolism following total knee replacement surgery- 110mg (ELDERLY over 75 years, 75mg) 1-4 hours after surgery, followed by 220mg (ELDERLY over 75 years, 150mg) once daily for 10 days, to be taken on the first day after surgery

Or
Rivaroxaban▼ tablets 10mgDose: 10mg once daily, starting 6-10 hours after surgery, provided that haemostasis has been established
5 weeks treatment for hip replacement
2 weeks treatment for knee replacement

Prescribing Notes