ACE Clinical Guidances (ACGs)

[also known as Appropriate Care Guides]

ACGs provide concise, evidence-based recommendations to inform specific areas of clinical practice and serve as a common starting point nationally for clinical decision-making. ACGs are underpinned by a wide array of considerations contextualised to Singapore, based on best available evidence at the time of development. Each ACG is developed in collaboration with a multidisciplinary group of local experts representing relevant specialties and practice settings. ACGs are not exhaustive of the subject matter and do not replace clinical judgement.

Published on 28 May 2018
Last Updated on 28 May 2018
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This Appropriate Care Guide (ACG) gives guidance on selecting an appropriate anticoagulant, minimum treatment duration, and when to extend therapy.

A supplementary guide on switching between anticoagulants is included.

Download the PDF below to access the full ACG.

Key Messages
1. Unless contraindicated, treat patients with warfarin or a non-vitamin K antagonist oral anticoagulant if they have proximal deep vein thrombosis or pulmonary embolism.
2. Use warfarin if creatinine clearance (measured with the Cockcroft-Gault formula) is less than 30 mL/min.
3. If patient has active cancer, use low molecular weight heparin.
4. Continue anticoagulation for at least three months. Consider extended treatment if recurrence risk is high.
5. Review patients on extended treatment at least once a year.


VTE - Treating with the right anticoagulant and duration (May 2018) Supplementary guide - Switching between anticoagulants (May 2018)