LUMBAR PUNCTURE-RELATIVE CONTRAINDICATIONS

SUMMARY

1. Active bleeding, severe thrombocytopenia (platelet counts <50,000 to 80,000/microL), or an international normalized ratio (INR) >1.4, without correcting the underlying abnormalities

2. Unfractionated intravenous heparin drips: 2-4 hours

3. Low-molecular-weight heparin: 12-24 hours

4. Warfarin: 5-7 days

5. Newer oral anticoagulants (NOACs), apixaban, edoxaban, and rivaroxaban: 72 hours

6. Dabigatran should be withheld 48 to 96 hours based on renal function

7. Subcutaneous heparin: <10,000 units per day is not believed to pose a substantial risk for bleeding

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].