Recommendations for Considerations in Managing Anticoagulants

Referenced studies that support the recommendations are summarized in the Online Data Supplement.

COR	LOE	Recommendations
1	C-LD	1. For patients with AF receiving DOACs, optimal management of drug interactions is recommended for those receiving concomitant therapy with interacting drugs, especially CYP3A4 and/or p-glycoprotein inhibitors or inducers (Table 13).1–7
1	B-R	2. For patients with AF receiving warfarin,* a target INR between 2 and 3 is recommended, as well as optimal management of drug-drug interactions, consistency in vitamin K dietary intake, and routine INR monitoring to improve time in therapeutic range and to minimize risks of preventable thromboembolism or major bleeding.8–10
3: Harm	B-NR	3. For patients with AF, nonevidence-based doses of DOACs should be avoided to minimize risks of preventable thromboembolism or major bleeding and to improve survival.11,12

^*Excludes patients with mechanical valves.