Contraindicated in:
- Active bleeding
- CCr >95 mL/min (↓ effectiveness)
- Concurrent use of other anticoagulants or rifampin
- Presence of mechanical heart valves or severe mitral stenosis
- Moderate to severe hepatic impairment
- Triple-positive antiphospholipid syndrome (↑ risk of thrombosis)
- Lactation: Lactation.
Use Cautiously in:
- Elective/planned invasive/surgical procedures (discontinue at least 24 hr prior to ↓ risk of bleeding)
- Premature discontinuation (↑ risk of ischemic events)
- Neuroaxial anesthesia/spinal puncture (↑ risk of spinal/epidural hematoma and potential paralysis)
- Renal impairment (↓ dose for CCr 15–50 mL/min)
- Deteriorating or improving renal function (may require dose change)
- Body weight
60 kg (requires lower dose) - Rep: Women of reproductive potential
- OB: Use during pregnancy only if potential maternal benefit justifies potential fetal risk
- Pedi: Safety and effectiveness not established in children.