Stopping Apixaban pre surgery. Info I... - Atrial Fibrillati...

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Stopping Apixaban pre surgery. Info I didn't know.

Bagrat profile image
37 Replies

Went for my pre op assessment yesterday. Was expecting to be told to stop my Apixaban 48 hours before. This was the case but the nurse explained when you stop it depends on your GFR. (one of the renal function tests they do routinely.) They have a chart and it depends on this result as to when you stop. I assume if kidneys excreting apixaban more slowly you stop it earlier.

Does anyone know if that's correct. I'm just nosey!

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Bagrat
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37 Replies
BobD profile image
BobDVolunteer

Not heard of this but it makes sense.

Bagrat profile image
Bagrat in reply toBobD

Yes Bob that's what I thought.

LPE44 profile image
LPE44

Apparently, from the following article, only 25% of Eliqus is eliminated by the kidneys. The rest is through the liver.

reuters.com/article/us-drug...

Also, the half-life of Eliqus is 12 hours - so it leaves your system quickly. However, it does make sense that if your GFR is low, the rate at which Eliqus leaves your system will be longer.

Bagrat profile image
Bagrat in reply toLPE44

Thanks. Sorry you've had such a rough ride. I'm a lucky soul

LPE44 profile image
LPE44 in reply toBagrat

Well it is better than the alternative :-D

Best of luck to you!

irene75359 profile image
irene75359

Not sure, it sounds logical though.

Bagrat, is this surgery to do with your recall a month ago? If so, hoping all goes well and sending very best wishes. xx

Bagrat profile image
Bagrat in reply toirene75359

Yes irene75359 having another lumpectoy same boob different place! Very fortunate I'm having annual mammograms from previous lumpectomy or I would have remained in blissful ignorance. Much better caught now. Will need radiotherapy this time though then hormone tabs. Thanks for your good wishes ( and good memory!!)

MydogBrandy profile image
MydogBrandy

Hi Bagrat , I stopped mine 48 hours before, hope all goes well.

shorttail profile image
shorttail

I stopped mine 2 days before and was not able to restart for 5 weeks.

Good luck and best wishes.

allserene profile image
allserene in reply toshorttail

Had a colonoscopy a few weeks ago and they said stop apixaban 48 hours before, and resume immediately after the procedure.... Never had warfarin, but it sounds really fussy, whereas apixaban/eliquis is much quicker/easier to turn on and off... Here in Wisconsin, Warfarin is $6 a month and Apixaban is $640...

Bagrat profile image
Bagrat in reply toallserene

Good grief. Praise the Lord fot UK NHS while it lasts!!

allserene profile image
allserene in reply toBagrat

The Americans just blank me when I tell them my mother got a hysterectomy at age 92 in Leeds, and it was a superb job at 2 days wait and free... My Wisconsin wife had always been told that Britons over 55 are given 2 aspirin and sent home by the 'socialist government death panel'.. The UK will wonder what has hit it if the US Billionaires get their hands on the NHS... Imagine losing you house and your savings and being made bankrupt and ending up in homeless shelter..... That happens in the US all the time. Medical bills are the biggest cause of bankruptcy, and the majority HAVE insurance...

Desanthony profile image
Desanthony in reply toallserene

My son's partner is American and her brother's family is now bankrupt purely because his wife got cancer. His wife is a hospital doctor and he is a soft wear engineer. Unfortunately, she was diagnosed with breast cancer last year and had to have chemo therapy the cumulative effects of the chemo caused her problems with sepsis and she had to spend time in hospital so now they are bankrupt with two daughters and no home etc and I imagine she will not be able to to get full healthcare insurance again. Absolutely shocking.

Bagrat profile image
Bagrat in reply toDesanthony

It's awful. People have no idea......

allserene profile image
allserene in reply toDesanthony

Indeed...and the worst thing about it is that many Americans feel its normal and right to lose everything, and the NHS is socialism/communism.. Many of them rely on their church for help, and that is a big driver behind the intense religiosity . You need a tribe... Every 1st world country except the US has universal healthcare, but the US is conditioned to think they are number one in the world at everything .. I have been a US citizen since 2010, but you can tell I am not assimilated as I think other countries have good cultures/ideas too... If the UK allows the US into the NHS they will be eaten alive... We pay $30k in insurance in any year that we have problem... say £25,000...... and only $20,000= £17,000 if we dont see the doc at all... and those are minimums if we hit the insurance requirements.. Get it wrong and you can hit £300,000 easily...

Bagrat profile image
Bagrat in reply toallserene

Oh good heavens. That is so scary. I had no idea that it was that bad.

healme profile image
healme

Thats interesting I havnt had any "routine renal function tests" since starting Apixaban almost 3 years ago. But alas now J am having liver problems. There must be a connection surely ?

Bagrat profile image
Bagrat in reply tohealme

Not sure there will necessarily be a connection but should have base line liver function and renal blood tests before starting apixaban. I only had renal and when I asked for tests after a year one of my LFTs was a bit high but acceptable evidently and it has come down again now.

Desanthony profile image
Desanthony in reply tohealme

I get tested every 6 months. Full bloods.

healme profile image
healme in reply toDesanthony

Thank you for your reply. I should be more proactive with my healthcare I rarely see the same GP in my very busy practice so I have probably slipped under the radar when it comes to blood tests etc.

allserene profile image
allserene in reply tohealme

In 1998 I asked my GP in Yorkshire if they did annual checkups. They said no but I could have annual blood tests every year if asked for one. The bloods would show 34 conditions.. Don't know if they included PSA (prostate). In the US they do annuals and it showed my PSA was high and increasing, so I did the full test and it showed MALIGNANT cancer. I got zapped with Cyberknife (not available UK), and now my PSA is 0.4 NOT 6.4 and increasing fast ... Prostate cancer is the second highest killer of men. The UK doc wanted me on blood pressure tablets (20 years later I am 128/78).... and the nurse told me (in confidence), the Doc gets a NHS bonus based on the number of people he can turn into zombies with BP tablets !

Desanthony profile image
Desanthony in reply toallserene

cyber knife is now available in UK but I think only at a few centres. I went to The Royal Marsden and it is avilable there so imagine it may be at a few other top centres by now. They generally do not include PSA and I definitely don't think they would have back then. Too many GP's say it is not a good indicator of cancer - no it is not but it is an indicator that something is wrong and should be checked and if it is cancer then the earlier it is caught and treated the better. Early Prostate cancer is curable as mine seems to have been 3 years post treatment. However when my PSA started going up my GP refused more frequent tests! Therefore I feel my cancer could have been treated at least a year earlier as born out by my oncologists opinion when I saw him. He would have started treatment or at least done a biopsy when my PSA was 3 points lower and the tumour smaller and not "bulging" as if breaking out of thecapsule. Also do not ring for results of blood tests to be told by the receptionist that everything is OK. Ask for a copy of the results to be sent to you or ask the GP's surgery for a copy and make a routine appointment to talk them through. I found to my cost that I hd had a blood test which came back low that was never mentioned to me and just lay on my file for 2 years until I had a problem and a new doctor at the surgery found it and found that my blood count was still low so untreated for 2 years. Blood test results put on file an not actioned and I am pretty sure I called the receptionist and she would have said all fine!

allserene profile image
allserene in reply toDesanthony

Interesting stuff and good info for men who don't take prostate cancer seriously enough.. My PSA was only 6.4 but was increasing fast year on year... My doctor told me to consider Cyberknife and I mulled it over for couple of weeks.... I told him I was just about ready to decide, but the dire warnings of ending up in nappies etc was scary. I got a letter after the biopsy that said "MALIGNANT" in capitals and that makes you gulp. I knew that most men die with it, and not from it, even when its malignant, but I didn't want it growing inside me....... The doc leaned over the desk and got in my face and said '"Men die from this". He told me about one of his patients who had a loaf sized tumour on their shoulder, and it was prostate cancer that can go anywhere. Anyway I got it done in 2007 and my PSA is now 0.4.... I keep googling famous men back to the 1950s, and it is surprising how many died from prostate cancer... Fred Dibnah and Richard Dimblebly and a myriad of others.. Five, one hour Cyberknife sessions fixed it and my guts etc work just fine 2 .5 years later. Men of all ages should have annual blood tests to look for everything, and the PSA add-on test cost me 10 dollars..say 8 quid... ps My toenails were a rotting, stinking mess for 15 years with fungus that I cold not cure. The online 'angels of death' told me if I took Lamasil pills it would kill my liver and leave me crippled. I took it anyway in early 2017 with zero side effects, zero fungus re-occurrence, and now I have the toenails of a top international toenail model ! This getting old stuff is a constant battle, but so far so good......

Desanthony profile image
Desanthony in reply toallserene

Great post thanks. I hope more people take notice of this men and women - women get your men to get tested.

Desanthony profile image
Desanthony in reply tohealme

the cardio department at my hospital informed the GP that this shoud be done.

JaneChapple profile image
JaneChapple

I think anyone on these sorts of drugs should have routine momitoring surely? Thats the problem with NOACS/DOACS at least with hubby on warfarin he gets regular xhecks with INR with these others ypu are not monitored at all.

JaneCx

Bagrat profile image
Bagrat in reply toJaneChapple

You are supposed to have 6- 12 monthly liver and kidney function tests. GFR mentioned in OP is one of the kidney ones. I ask yearly and for ECG because of flecainide

Auriculaire profile image
Auriculaire in reply toBagrat

My GP here in France gave me a prescription (along with the one for Apixaban) for what I think is GFR and creatinine and liver enzymes and told me to go for the tests after 3 months. We already get liver and kidney function tests as part of the regular battery of blood tests.

DianeArnold profile image
DianeArnold

Hi Bagrat. Just to mention my recent experience. I was advised to stop my apixaban 48 hrs before my recent hysterectomy. Unfortunately it was restarted too soon after surgery, which went well, and I was rushed back into hospital 5 days after the op with massive vaginal bleeding! This left me with anaemia and muscle wastage, of which I am still recovering 7 weeks later! Slowly recovering now, but do check when best to restart afterwards. Good luck with whatever you are to have.

Bagrat profile image
Bagrat

Thank you. I had wound probs with same op 2 years ago. I was on warfarin then swapped last year so hoping better this time especially as I told consultant I want extra diathermy this time!!

DianeArnold profile image
DianeArnold

Good luck with that. I shall be thinking of you.

healme profile image
healme

Sorry Bagrat. Having read your full post I should be wishing you luck with your operation instead of moaning about my lack of blood tests. Good luck I hope everything goes well.

Bagrat profile image
Bagrat in reply tohealme

That's very kind but please moan away. Tbat's the joy of a forum, a safe space to let it all hang out!!

Khatpi profile image
Khatpi

Best of luck to you Bagrat , with your upcoming procedure. Take good care of yourself. Sarah from San Diego.

Bagrat profile image
Bagrat in reply toKhatpi

Thank you. Op went well but unfortunately they ?scratched my uvula putting e/t tube in and it's swollen somewhat so I'm very aware of it. All good otherwise. Oh and i learnt something else. Told anaesthetist I'd stayed on my magnesium until 24 hours before. He said that was ok but magnesium does affect anaesthesia as he put it "but in a good way".So worth mentioning.

Rostom profile image
Rostom

What fascinating posts!

My only addition is that I began Apixiban just over a year ago (and was quite worried about doing so) and have had absolutely no ill effects: I have three-monthly blood tests.

I would not be able to order more supplies of Apixiban if I did not have a blood test booked.

Rostom profile image
Rostom

Glad your operation went well, Bagrat and hope your throat is less sore

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