Xarelto - how long to stop before operation

[consul]

As is normal I need to stop taking Xarelto before my upcoming operation. Generally speaking, subject to of course doctor's advice, what is the general consensus as to how many days before hand should one stop and when exactly should one recommence - immediately after the operation ?

[Japaholic]

I cant say for your surgery BUT the ablation I am due in July I am told to stop taking it the day before (EG miss one day before) and start the day after (the following day) but it may be different for different doctors and different procedures.

[Bryonny]

Hospitals have guidelines about anticoagulation and what is recommended in terms of when to stop medication, if at all. My understanding is it will be based on type of operation together with your own personal medical history. Have you looked on AFA website to see if there is information there?

I had wisdom extraction, not an operation I know, and I was told to keep taking anticoagulant.

[rosyG]

Hi, I think the guidelines relate to whether there is a low, medium or high risk of bleeding with your type of surgery so you need individual advice. I also think your AF should be considered too so you might want to get a cardiology view on what your present status is and the third thing is to ask, after the operation, what the risk of bleeding is in your own case, given what happened during the operation. I'm not medically qualified but have been looking into this for myself and will do this before I have some minor knee ops soon.

[BobD Volunteer]

I think one problem will be that the NOACs are still quite new and a lot of doctors will still be thinking along the warfarin guidelines of five days. Since these NOACs only have a short half life (12 hours) stopping the day before would seem adequate but I doubt many will come to the same conclusion. Really we should not give such advice no matter how right we may be. You must discuss this with the team at your pre-op assessment appointment and accept their answer but by going prepared with some facts you may be able to ensure that you strike the right balance between protection and risk.