DOAC Restart After GI Bleed — RACP Adult Medicine MCQ

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ModerateEmergency MedicineDOAC Restart After GI BleedRACP Adult Medicine

A 70-year-old man on rivaroxaban develops acute upper GI bleed. After endoscopic haemostasis, when can rivaroxaban restart?

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Correct answer: E — 48–72 hours after endoscopic haemostasis

Restart DOAC 48–72 hours after confirmed haemostasis for high CHA₂DS₂-VA. PPI therapy essential. Consider switching to apixaban (lower GI bleed rate).

Reference: eTG – 2025 – Haematology; ISTH – 2022