A 74-year-old woman with a recent hip fracture has been started on Enoxaparin for VTE prophylaxis. She also takes Apixaban 5 mg BD for atrial fibrilla...

Question

A 74-year-old woman with a recent hip fracture has been started on Enoxaparin for VTE prophylaxis. She also takes Apixaban 5 mg BD for atrial fibrillation. The junior doctor has prescribed both concurrently. What is the MOST important concern?

Accepted Answer

The Enoxaparin is unnecessary as she is already on therapeutic-dose Apixaban for AF, and dual anticoagulation significantly increases bleeding risk

Answer

Enoxaparin and Apixaban work on different pathways and can safely be combined

Answer

Enoxaparin should be switched to Warfarin

Answer

Apixaban should be stopped and only Enoxaparin given

Answer

Both should be stopped and Aspirin given instead

uk-dgm MCQ (SBA): Dual Anticoagulation Error - DOAC and LMWH

A 74-year-old woman with a recent hip fracture has been started on Enoxaparin for VTE prophylaxis. She also takes Apixaban 5 mg BD for atrial fibrillation. The junior doctor has prescribed both concurrently. What is the MOST important concern?