Stopping Rivaroxaban before surgery

I am on a joint Eye-ENT waiting list for a tear duct operation, which the surgeon told me is likely to be "very bloody". We discussed my anticoagulation at the clinic and she wrote to my GP afterwards, requesting that she advise me about stopping Rivaroxaban before surgery.

Quite out of the blue, I have received a letter from the surgeon saying that they had taken advice from their cardiologist (who I have never seen) and that I should stop Rivaroxaban "blood thinners" three days before surgery and recommence the day after. I am cared for by a cardiologist at a different hospital where I had heart surgery 5 years ago and, to the best of my knowledge, there has been no contact between the two cardiologists.

No mention has been made of any bridging medication e.g. heparin. Also there is no mention of pre-operative assessment. Does this seem like standard advice/procedure or should I query with GP, eye surgeon or cardiologist(s)? I have (apparently) permanent AF but the rate is well controlled.

8 Replies

  • Problem is no two experts seem to agree. I have noticed the general time to be two days but since Rivaroxaban has such a short half life it could be said that one day was enough. It is all about risk management and everybody has differing views apparently. Sorry you are in this quandary.


  • Hi Mrspat, as Bob D Says two days is probably more common, and that's what I did for a knee op, but they don't usually bridge unless they consider you high risk. But there appears to be little consistency here across various hospitals and doctors.

    Be well


  • Thank you both. I don't have a date for the operation yet but am guessing 2-3 months if they keep to the 18 week target. I have already turned it down once before, 4 years ago, as the symptoms cleared up, as indeed they have now. A quandary whether to have the operation at all.

    If I am not offered a pre-op assessment I think I may go and have a chat with my GP.

  • I am due to have a "Bilateral Medial Retractor Plication" on my two eyelids and the consultant said no need to stop my Rivaroxaban !! One just doesn't know what is best.

  • General consensus is two days before the op. I was told this by a well informed GP I trust and it all came out fine. Started back on the tablet the next day. I would think you would have to have a pre-op appointment, which should cover these things. Raise this point - but don't let them say you should stop 12 days before as they did with me! I don't think the consultant even knew what Rivaroxaban was! 😳

  • I am due eye surgery (cataract) this coming Wednesday and have been told NOT to stop taking my anticoagulant

  • I don't think cataract surgery involves much cutting or blood loss. My planned operation involves making a new pathway from my eye to my nose via the nasal cavity. This will involve cutting flesh and possibly bone. Hence lots of gore!

  • Hi there,

    I was told to stop taking xarellto 3 days before a bronchoscopy, but only one day before tooth extraction. Didn't have the bronchoscopy on the day as a scan I had showed the problem and I had no problems with bleeding following two separate tooth extractions.

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