Cautions and contra-indications to anticoagulation

 

Before starting anticoagulation consider cautions and contra-indications to anticoagulation:

 

  • Inherited bleeding disorder e.g. haemophilia, von Willebrand disease
  • Acquired coagulopathy: seek advice from duty haematologist
  • Thrombocytopenia, platelet count less than 50 x 109/L: dependent on causation of thrombocytopenia, seek advice from duty haematologist
  • Acute gastroduodenal ulcer
  • Active bleeding of any sort
  • Acute stroke
  • CNS surgery within the previous 3 months
  • Severe uncontrolled arterial hypertension
  • Advanced liver disease
  • Severe renal impairment – risks increase if eGFR less than 30ml/min
  • Previous history of heparin-induced thrombocytopenia - see p27