Thrombolysis on DOAC — RACP Adult Medicine MCQ

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HardNeurologyThrombolysis on DOACRACP Adult Medicine

A 72-year-old man on apixaban develops a stroke. Can IV thrombolysis be given on a DOAC?

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Correct answer: E — Yes if last dose >48 hours ago OR anti-Xa <0.5 IU/mL

IV thrombolysis permitted if last DOAC dose >48 hours OR drug level below threshold. EVT not affected by DOAC status.

Reference: Stroke Foundation – 2024; NSW ACI – 2025