3. Make a treatment decision

3.3 Changing warfarin to a DOAC

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Our clinical team periodically review the information on these pages to make sure that we are providing you with the most up to date medical information and services.

  • Last review 28.04.2026
  • Next review due 28.04.2027

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Frequently Asked Questions

Why am I being asked to change my warfarin to a DOAC

DOACs thin your blood and help to prevent blood clots and strokes just as well as warfarin. There are some advantages to taking them over warfarin that we think may suit you. These include not needing to have an INR check done.

Why dont you just change it straight away for me?

Although changing to a DOAC is a good option for  most its not  suitable for all patients. You can use the FAQ and information leaflets in the download section to help you decide if it is right for you. Your healthcare professional will also double check that  this is the best treatment for you before prescribing.

Do DOACS work as well as warfarin?

Yes they do….

Warfarin reduces the risk of stroke from 40:1000 people to 14:1000 people.

DOAC medications are as effective as warfarin in reducing the risk of stroke.

 

Is a DOAC as safe warfarin?

Bleeding risks are very similar

The trials have shown that bleeding in the brain is much less common with DOAC agents than with warfarin (  1-5:1000 per year for DOAC and  5-7:1000 for warfarin ) Bleeding in the gut occurs in 8-30:1000 per year which is similar to that of warfarin 10-20:1000 people every year

Do I still need an INR test?

No regular blood tests / INR tests are necessary for DOAC treatment. However, this means you have to remember to take your medications at the specified time as we have no readily available ways of checking your blood levels.  You will need 6 monthly or yearly blood tests for your kidney and liver functions.

Do DOACs interact with lots of things?

DOAC  medications are not known to interact with food substances or alcohol and interact with very few medications.

Can DOACs be reversed if I have a severe bleed?

Although there is no currently available antidote to this group of medications there are  effective hospital treatments available should the need arise. Unlike warfarin the medication is cleared from your body quite quickly. It would be important to seek urgent medical attention if you start bleeding though as it could not be managed safely at home.

What do I do if I have serious bleeding?

Occasionally, you can have serious bleeding from taking edoxaban. This can be dangerous and needs urgent medical attention.

Contact your doctor or anticoagulant clinic, or go to A&E straight away if:

  • you have red pee or black poo
  • you get bruises that happen for no reason, or bruises that are larger than you’d expect or that keep growing in size
  • you get nosebleeds that last longer than 10 minutes
  • you have blood in your vomit or you’re coughing up blood
  • you get severe headaches
  • you have any bleeding from a cut or injury that won’t stop or slow down

These are symptoms of serious bleeding. If you experience serious bleeding, stop taking edoxaban

what can I do to prevent bleeding?

While you’re taking edoxaban be careful when you do activities that might cause an injury or a cut or bruising. It can help to:

  • avoid playing contact sports or other activities that can cause an injury – such as football, rugby, hockey and horse riding
  • wear gloves when you use sharp objects like scissors, knives and gardening tools
  • stop wet shaving or removing hair with wax – use an electric razor or hair-removing cream instead
  • take dentures (false teeth) or retainers out for a few hours a day, if you wear them, to give your gums a rest – don’t wear dentures or retainers that don’t fit properly
  • tell your doctor, dentist or nurse that you take edoxaban before you have any medical or dental procedures or surgery – this includes vaccinations and routine appointments with the dental hygienist

What do I do if I forget to take my edoxaban tablet?

Take your tablet as soon as you remember. If you only remember the following day, leave out the forgotten dose. Take your next dose at the usual time, and then carry on as normal.

Never take more than 1 dose in a single day.

If you’re worried, speak to your pharmacist or doctor.

If you often forget doses, it may help to set an alarm to remind you. You could ask your pharmacist for advice on other ways to remember your medicines

Do some people develop allergies to edoxaban?

In rare cases, edoxaban can cause a serious allergic reaction (anaphylaxis).

Urgent advice:Contact a doctor straight away if:

  • you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
  • you’re wheezing
  • you get tightness in the chest or throat
  • you have trouble breathing or talking
  • your mouth, face, lips, tongue or throat start swelling

These are warning signs of a serious allergic reaction. A serious allergic reaction is an emergency.

Is it ok with pregnancy or breastfeeding?

Edoxaban isn’t normally recommended during pregnancy or while breastfeeding.

Non-urgent advice:Tell your doctor if you’re:

  • trying to get pregnant
  • pregnant
  • breastfeeding

How do I switch from warfarin to edoxaban?

If you need to switch from warfarin to edoxaban, your doctor will advise you when to stop taking warfarin. This will probably be a few days before you start edoxaban.

Your  healthcare professional will do a blood test called the international normalised ratio (INR) to check how quickly your blood’s clotting. This is to help decide exactly when you should start taking edoxaban. Your INR will need to be less than 2.5 before you can start the new medication

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