Advice on Missing a dose of Rivaroxoban.

[kenthynne]

Hello , I would love some advice. I have been diagnosed with a frozen shoulder which is giving me dreadful pain. My GP has suggested an injection into the shoulder which he says I would help enormously. Can I miss one day of taking my anticoagulant to allow me the opportunity to get this treatment. I take it that I can restart my rivaroxoban the following day. Any advice would be appreciated. Thanks.

[meadfoot]

I take rivaoxaban and had to stop it for three days in advance of an ep study. Started it again as normal thereafter, no problems.

Are you intending to stop it due to the injection if so has the doctor recommended that or is it your decision due to worries over bleeding. If your doctor has not instructed you to stop I would ask if he thought it necessary. It could be due to some potential reaction between the particular injection and rivaoxaban but I do not have any medical training so could not comment, if your doc has asked you to stop it for a day then so be it.

I can add that i have had tooth extraction, injections for other dental work, flu jabs, blood tests and various other injections without any bleeding problems whatsoever and have not stopped the rivaoxaban as agreed with doc and dentist.

With regard to your frozen shoulder I have recently had physio for mine and it has sorted it out completely. My physio says frozen shoulder symptoms typically can last about eighteen months and I was close to that point when I gave in to have physio treatment so it was on its way out anyway at that point I suspect. It's quite restrictive and painful isn't it.

Good luck.

[kenthynne in reply to meadfoot]

Hi meadfoot , my intention was to just stop taking my rivaroxoban for however long was needed to allow me to have this injection for the frozen shoulder. If it is only one dose I will miss then that will be brilliant. My GP is going to ring me on Monday to decide the best course of action and because physio has not been as effective it looks as though I shall opt to have the jab. As you say the condition is very restrictive and very painful. I am looking forward to pain free days soon. Thank you and keep well.

[jennydog]

I recently had a steroid injection into my shoulder. I didn't stop taking Pradaxa.

I do sympathise with you. Everybody takes shoulders for granted but when something goes wrong the pain is awful.

[judyt in reply to jennydog]

I have had frozen shoulders, first line of treatment was Physio but that just made the first shoulder worse and started off the second one. Went to an Orthopaedic specialist for advice and one cocrtizone injection on each side sorted the whole problem out permanently. 2006 I think it was, little niggles since then due to the way my shoulders are built but I know what to be careful of and have no real problem any more.

[kenthynne in reply to judyt]

Hi judyt, here's me complaining about one frozen shoulder and you've had two !!!!. I suspect that cortizone is the type of injection the doc is going to give me so fingers crossed that it will do the trick. As I mentioned physio did help a wee bit but I fell awkwardly recently and it made things worse. Thanks for your imput and I will keep everyone up to date once things have been done. Keep well and safe x

[kenthynne in reply to jennydog]

Hello jennydog, it could be that my doctor may even give me this injection without stopping the rivaroxoban so really looking forward to pain free days. All I was worried about was possible ramifications of missing a dose of the anticoagulant. But everyone seems certain missing one dose should be fine so looking forward to getting rid of this pain and ache in my shoulder. Thank you for you advice it is very much appreciated. Keep safe and well. x

[PeterWh]

My suggestion is push hard not to miss a dose. See my comments in a recent post re dentist treatment.

[01maxdog]

Hi. I'm having an injection in my knee at the end of May for arthritis and have to stop my rivaroxaban 2 days prior . I know there will be no problem as I recently had 3 teeth extracted and had to stop for the same time . I just resumed the normal dose at the normal time later that same day .

[PeterWh in reply to 01maxdog]

See the comments that others and I made on NOT stopping anticoagulation for having any form of dental treatment including. I wrote a number of comments that were given to me by my dentist.

In fact NICE specifically state that it is OK as long as INR is under 4.0 (four). dentist told me if I saw anyone else to refer them to that. Even for multiple extractions do not stop. Also an article on this in new AFA Newsletter.

As for hospitals procedures many consultants and doctors are stuck with what they were taught which was to stop warfarin. I was told that many procedures can and should be done continuing on anticoagulation.

As it happens last Friday I saw a consultant at the Heart Centre and they are going to do an angiogram on me in a few weeks but he said that although I would have to stop warfarin for that procedure I had to have heparin daily before and afterwards so as to maintain anticoagulation.

There are a number of articles and comments that identify that the period after stopping and then restarting again are higher risk times than normal.

[Luisa1987 in reply to PeterWh]

i thought it was not good to stop rivaroxaban and there is no inr level with it as it thins the blood in a different way to warfarin.