Warfarin

[marydel]

Hi guys

Haven't posted on here for a long time. Just a question

I have to come off warfarin so that I can have an injection in my spine. How long does it take to come out of your system

[BobD Volunteer]

Normally stop five days prior to any operations or procedures. Your doctors should tell you that when they discuss what you will have done.

Bob

[hondajazz]

Yes three to five days but as bob said your health team doing the procedure should tell you that and you should have an INR before it and they usually tell you to resume your latest dose the same day but best ask themas each of us is different.

[Offcut]

2 to 7 days Wafarin response is very variable. Typically, within 2 to 3 days there is a significant reductiion in the effect and within about 5 days anticoagulation effect has largely resolved. There are antidotes available and diet will have an impact.

[MarkS]

I recently had a minor op. I discussed the warfarin with the consultant and we agreed I'd just drop INR to 2 on the day. That worked well, the surgeon was happy with the bleeding and I was protected all the time.

It's worth asking if you can continue on warfarin. I think the less experienced doctors tend to panic at the mere mention of warfarin.

[Marion62 in reply to MarkS]

Hi MarkS

I also have to get my INR to 2 next month and have been told to stop warfarin 2 days before - may I please ask how you managed to achieve it? My INR fluctuates normally between 2 and 3.

Thanks

Marion

[MarkS in reply to Marion62]

Hi Marion,

I was on 2.5, so I cut my dose from 8mg to 7mg from 4 days before and it just gradually drifted down whilst I monitored it. Cutting your dose completely for 2 days is a little more drastic but would probably achieve the same thing. I would take an extra dose immediately afterwards. With a Coaguchek it's easy to monitor but you're a little more in the dark if you don't have one.

Mark

[Marion62 in reply to MarkS]

Thanks Mark

I rely on INR testing at the GP surgery and then get the result the next day. My routine test is actually on the first day I stop warfarin and I have asked for another a week previous so I at least have some idea what my INR is doing. (Hope GP approves both tests)

Thanks again for your help.

Marion

[rkoac1]

Yes can confirm. Ive been on Warfarin for over 20 years and each time Ive had to have any evasive procedure done in hospital Ive had to stop it 5 days prior to procedure. e.g. Last dose of Warfarin on Wednesday night if the procedure is scheduled for Monday morning. In my case with having a mech valve, I also need to take Clexane injections (approx 1mg to every 1kg of body weight) to cover me daily up until the last injection on the Sunday morning. Then go to hospital Monday morning for an INR check prior to procedure. In my case my normal Warfarin dose is alternating 4-5mg daily with therapeutic level 2.0-3.0. Then by Monday morning my INR levels have always been between 1.2-1.5. This has been the norm for me in the last 8 x evasive procedures Ive had to cease and restart Warfarin in the last 4 years. Most recently Monday just passed lol.

Always heed the advice from your doctors or surgeon because they know what level of INR is safe for them to work with without putting their patient at risk of clotting or bleeding out during surgery.