Avoid Overlapping Direct Oral Anticoagulants With Warfarin in Most Cases

Should warfarin ever be COMBINED with a direct oral anticoagulant (DOAC)...rivaroxaban (Xarelto), etc?

Rarely. If short-term anticoagulant overlap is needed, an injectable (enoxaparin, etc) is almost always a better choice than a DOAC.

Be aware, DOACs can raise INR...making it hard to assess warfarin's effect. Plus two oral anticoagulants is a recipe for mix-ups and harm.

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