Editing Peptic ulcer disease (section)

===Anticoagulants===
According to expert opinion, for those who are already on anticoagulants, the [[international normalized ratio]] (INR) should be kept at 1.5. For aspirin users who required endoscopic treatment for bleeding peptic ulcer, there is two times increased risk of rebleeding but with ten times reduced risk of death at eight weeks following the resumption of aspirin. For those who were on double antiplatelet agents for indwelling stent in blood vessels, both antiplatelet agents should not be stopped because there is a high risk of stent thrombosis. For those who were under [[warfarin]] treatment, [[fresh frozen plasma]] (FFP), vitamin K, prothrombin complex concentrates, or recombinant factor VIIa can be given to reverse the effect of warfarin. High doses of vitamin K should be avoided to reduce the time for rewarfarinisation once the stomach bleeding has stopped. Prothrombin complex concentrates are preferred for severe bleeding. Recombinant factor VIIa is reserved for life-threatening bleeding because of its high risk of thromboembolism.<ref name="Angel 2017"/> [[Anticoagulant#Directly acting oral anticoagulants|Direct oral anticoagulants]] (DOAC) are recommended instead of warfarin as they are more effective in preventing thromboembolism. In case of bleeding caused by DOAC, [[activated carbon|activated charcoal]] within four hours is the antidote of choice.