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DOAC management peri-dental procedure — GPhC CRA MCQ

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HardCardiovascular TherapeuticsDOAC management peri-dental procedureGPhC CRA

A patient takes rivaroxaban 20 mg every morning for atrial fibrillation and is booked for four adjacent dental extractions, a higher-bleeding-risk procedure. Renal function is stable. Which SDCEP plan is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Delay the morning dose until at least four hours after haemostasis

Option A is the SDCEP approach for a higher-bleeding-risk dental procedure in a patient who takes once-daily rivaroxaban in the morning: delay that dose and restart at least four hours after haemostasis. Option C exposes the procedure to near-peak anticoagulant effect. Option B creates excessive interruption and unnecessary bridging. Option D invents tablet splitting. Option E adds antiplatelet risk and changes timing without support.

Reference: SDCEP quick-reference guide: https://www.sdcep.org.uk/media/oreflwyz/sdcep-anticoagulants-quick-reference-guide.pdf