My surgeon wants me off blood thinners for 2 weeks before surgery. Other medications?

Hi everyone.

My surgeon wants me to stop apixaban for 2 weeks before my parathyroid surgery. This scares me as my father had a stroke when he went off warfarin for a minor procedure. Isn,t there an alternative drug I can use and just stop a day or so before the operation?


10 Replies

  • Your could ask your doctor about clexane. but you would have to self inject daily if you went that route. I think the two week thing is probably down to lack of experience of this relatively new drug (apixaban). It doesn't make sense to me since these NOACs have a very short half life anyway.


  • I have to stop my Apixaban 2days before ablation. 2 weeks seems a bit of a long time! They should also check your bloods on this too. I didn't know this until the ANP told me at my pre op. I take 10mgs a day ( 5 mg bd).

  • Ah...clexane. ..thought there was something. I think I need to talk to my cardiologist before the surgeon. Bloods too are important. Thx.

  • There's an article here on thyroid surgical practice in Australia:

    which indicates that most surgeons would bridge with heparin where there is any history of TIAs or stroke.

    The standard practice appears to be to stop warfarin 5-7 days before a thyroid procedure. As the others have pointed out, apixaban has a short half life so you could potentially stop it at an even shorter period.

    I would contact the hospital and suggest that apaixaban is stopped later, resumed again straight afterwards and you use heparin in the meantime.


  • The article is very interesting Mark, and helpful!

  • What about rivaroxiban ? I am coming up for an hernia operation and I am on rivaroxiban. My surgeon has suggested that I come off for 2 days before and 2 days after. I am going to check this with my GP as she persuaded me to go on the drug in the first place and seems quite up on it.

    I also recently had a tooth removed and done the same. The concensus seems to be that the drug tales 24 hours to clear your system. Of course my operation is probably minor to yours, but there has to bleeding nevertheless. Best of luck with whatever you decide to do

  • Hi .I have just had pace maker implanted and had to stop warfarin 5 days before ,so that the blood would clot quicker in surgery other wise to thin it would be disastrous ,went back on them day after .poppystorey

  • I have to stop Dabigatran 2 weeks before my next ablation and then go back on Warfarin after 48 hrs. The EP wants my INR to be between 2.5 and 3.0 for the procedure.

  • Thank you all for your replies. Its given me much to consider and talk to the cardiologist and surgeon about.

  • Yes, do get all the information you possibly can and nag the surgeons and cardiologist until you're certain the message has got through and you're 100% satisfied with their responses.

    This is an incredibly serious consideration for any of us who are on anticoags and need to come of them prior to surgery.

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