Discontinue treatment at least 5 days prior to any surgery; if patient reports new, prolonged or worsened dyspnoea. Central sleep apnoea including Cheyne-Stokes respiration; TTP. Patients w/ propensity to bleed (eg, due to recent trauma or surgery, active or recent GI bleeding, moderate hepatic impairment), at increased risk of trauma; history of MI w/ prior ischemic stroke; increased risk of bradycardic events (eg, patients w/o pacemaker w/ sick sinus syndrome, 2nd or 3rd degree AV block, or bradycardic-related syncope). Assess patient's clinical condition & concomitant medication as potential causes of bradyarrhythmic events & AV blocks prior to adjusting treatment. Avoid premature discontinuation. Concomitant use w/ medicinal products that may increase bleeding risk (eg, NSAIDs, oral anticoagulants &/or fibrinolytics); antifibrinolytic therapy (aminocaproic acid or tranexamic acid) &/or recombinant clotting factor VIIa. Not recommended to be used concomitantly w/ high dose ASA (>300 mg). Avoid co-administration w/ strong CYP3A4 inhibitors eg, ketoconazole, clarithromycin, nefazodone, ritonavir, atazanavir. False -ve results w/ platelet function test for heparin induced thrombocytopenia. May affect ability to drive & use machines. Moderate hepatic impairment. Pregnancy. Not recommended during lactation. Childn <18 yr.
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