Edoxaban Around Surgery: Hold and Restart Basics

Original guidance with a conservative bias. It does not reproduce guideline tables. Confirm local policy.

When to hold edoxaban before surgery

Let the procedure bleeding risk set the baseline hold. Extend for higher risk interventions. If renal function is reduced, scale the hold conservatively. Avoid neuraxial approaches at very low clearance.

Neuraxial cautions

For epidural, spinal, or intrathecal techniques, use stricter holds and respect hard stops at poor renal function. If a catheter is used, do not dose while it is in place.

Catheter gating

No edoxaban while a neuraxial catheter is in place. After removal, earliest restart is removal plus 24 hours, and then use the later of that time or the baseline post operative window.

When to restart

Restart once hemostasis is secure. Low or moderate risk procedures tend to restart sooner than high risk or neuraxial settings. Check the clinical course before resuming.

FAQ

How long to hold edoxaban before surgery

Use procedure risk and renal function to set timing. High risk cases need a longer hold. Lower clearance means more caution.

Should edoxaban be bridged

No. DOACs are not bridged.

When to restart edoxaban after surgery

Restart after adequate hemostasis. Be conservative for high risk and neuraxial contexts.

Get a timestamped plan that includes renal and neuraxial rules with the AnticoagPlanner calculator.

Sources

• MD Anderson. Peri Procedure Anticoagulants, V8 approved 2025.
• Institutional neuraxial catheter timing summaries derived from ASRA guidance.