We recommend that you carry an anticoagulation card with you at all times, in case of emergency. If you do not already have the card, please ask your pharmacist for one.
General safety information
Please let other healthcare professionals treating you know that you are taking an anticoagulant. This includes anyone who prescribes you medication or carries out a procedure, for example a dentist.
If you have any questions or concerns about your anticoagulant medication or you are starting any new medications or stopping existing ones, please talk to your doctor, nurse or pharmacist.
We advise taking your anticoagulant at the same time each day.
Please be aware if you occasionally or frequently forget to take your anticoagulant medication you may be at increased risk of blood clots/stroke/heart attack. If you require support with medications please contact your pharmacist for advice.
Late or missed doses
Apixaban or dabigatran
If you’re taking apixaban or dabigatran twice a day and you miss one of your doses, you should take it as soon as you remember if it’s still more than 6 hours until your next scheduled dose. If it’s less than 6 hours until your next dose, skip the dose you missed and take the next scheduled dose as normal.
If you accidentally take a double dose, skip your next scheduled dose and take the following dose the next day as scheduled.
Rivaroxaban or edoxaban
If you’re taking rivaroxaban or edoxaban once a day and you miss one of your doses, you should take it as soon as you remember if it’s still more than 12 hours until your next scheduled dose. If it’s less than 12 hours until your next dose, skip the dose you missed and take the next scheduled dose as normal.
If you accidentally take a double dose, take your next dose the next day as scheduled.
If you’re taking warfarin and you miss one of your doses, you should skip the dose you missed and wait to take your next scheduled dose as normal. Don’t take a double dose to make up for the one you missed.
Inform the clinician at your next INR appointment.
In the event of an overdose of your anticoagulant medication seek immediate medical advice.
The most common adverse effect of anticoagulants is bleeding.
You should seek immediate medical advice if:
- spontaneous bleeding occurs and does not stop or reoccurs. This includes bruising, bleeding gums, nosebleeds, prolonged bleeding from cuts, blood in the urine, stools, sputum, vomit, or eyes, and vaginal bleeding in postmenopausal woman.
- you have chest pain and nose bleeds lasting longer than 10 minutes
- sudden severe back pain (which may indicate internal bleeding) or in the event of a head injury
- stroke symptoms – For symptoms, please visit the NHS website at www.nhs.uk/conditions/stroke/symptoms/
- shortness of breath/chest pain