Steroid injections and Riveroxaban

[Lizty]

Hi.… went for a steroid injection in my hip and the young doctor said that my consultant should have mentioned that I was on Riveroxaban as he couldn't give me a joint injection because of the risk of internal bleeding. I have now been diagnosed with a thyroid nodule and have to have a fine needle aspiration/biopsy. [Nothing comes singly!!] Anyone got any ideas about whether I should come off R'ban,,,,, for small ish procedures? By the way, I didn't have to come anti-coagulants for my ablation...… ???

[Hidden]

A lot of this is down to the Dr carrying out the procedure.

I had to stop AC for my ablation, but carried on taking it when I had a colonoscopy

I suggest that you try and contact the department carrying out the procedure and ask them, or get your GP to do it (good luck with that!)

[Lizty in reply to Hidden]

Thanks Mike.. will try that.

[BobD Volunteer]

When I had an endoscopy last year I asked and was told nothing they would do needed to stop anticoag so best to check with the epartment concerned. Sadly many doctors are scared of anticoagulation quite unnecessarily .

[Lizty in reply to BobD]

Yes... agree.... even GPs don't always know the answers....

[Buffafly]

I had a steroid injection in my hip (I'm on Apixaban though) with no mention of a problem, and there wasn't one! Maybe depends on the skill of the doctor, mine was done by a specialist physiotherapist.

[Lizty in reply to Buffafly]

Thanks Buffafly……… I think he must have been being over-cautious.....but irritating as I had waited so long for the injection and then to hit this problem. I will contact the consultant who referred me to see if I can arrange another. It is amazing how many doctors have so little idea about anti-coagulation issues... each to their own field I suppose.

[Dodie117 in reply to Buffafly]

I have been told that steroid injections for my dodgy knees is a no-no due to AF and apixaban.

[suenygaard in reply to Dodie117]

I am on apixaban and have had many steroid injections in both knees, as well as my foot. I informed the provider each time that I was on an anti-coagulant, and they were not concerned at all. I have never had a single issue with the injections, not even any bruising.

[baba]

I had to stop anticoagulant for thyroid fine needle biopsy. I got instructions in the appointment letter. Usually done by radiographer with ultrasound.

[Lizty]

Thanks Baba. No instructions have come in my appointment letter, although they did say to let the department know.. when I came... if I was on any medication. Hope your biopsy was ok.... yet another slightly nerve-wracking experience! Isn't getting old all fun and games!!

[baba]

"they did say to let the department know.. when I came... if I was on any medication"

Better to contact them beforehand to ask about stopping the anticoagulant.

[Lizty in reply to baba]

Have left a message Baba. But have just had another thought. Did you have to come off it for 24 hours or more? I could probably arrange 24 hours by careful timing...…!

[baba in reply to Lizty]

I think 3 days, but the thyroid is a highly vascular, so there is a risk of bleeding, much more so than endoscopy or cataract surgery for example.

[Polski]

Bleeding near the backbone can be a serious issue. Could it have depended on exactly where the injection would have been?

[Lizty in reply to Polski]

Maybe... still awaiting confirmation from the team....

[Robinson1]

No I have had 2 Steroid injections and each of my hips and neither time did I come off of my Xarelto. My doctor said that it was good that I was on a blood thinner because it could prevent a possible blood clot in my hips.

[Lizty in reply to Robinson1]

Now that is interesting!! I am awaiting replies from radiology and orthopaedics... and 111! We shall see what the outcomes are!

[Lizty]

Just had a very useful conversation with a doctor on 111. He said that haematologists are the best people to advise... rather than EPs?

His son is an EP, so this also gave me confidence in his advice which was as follows -

As the responsibility for giving a procedure is down to those who give it....then, we should allow them to make the decision on whether or not to be off/on medication.

I found this a very fair reply... and guess I can understand the thinking. So, taking all advice on board, I shall make absolutely sure that, in advance of any future procedure, I have a quick discussion with the department well in advance of my appointment!

Guess that also explains the very different responses here to my original question. Some radiologists may have different views or desire to take on the responsibility. Might also depend on chad score? MIne is quite low at 2. [female over 65]

Thank you for all HU helpful replies.... and especially to 111!