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5 Higher-bleeding-risk dental procedures For procedures with greater bleeding risk (multiple extractions, complex surgical extractions, periodontal surgery), guidance recommends: 5 For apixaban or dabigatran (twice daily): skip the morning dose on the day of treatment For rivaroxaban or edoxaban taken in the morning: delay the morning dose until at least 4 hours after bleeding has stopped For rivaroxaban or edoxaban taken in the evening: no change needed For warfarin: check INR within 24 hours of treatment, and proceed if its below 4 Surgery and other invasive procedures For elective surgery or invasive procedures (endoscopy, colonoscopy, joint replacement, cataract surgery), discuss anticoagulation timing with your surgical team and your GP at least 1 to 2 weeks in advance

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