apixiban and biopsy

[Renault4]

I am due an endoscopy and it might involve biopsies. I am on apixiban any idea how long I should be off it before the procedure?

Many thanks

[Paulbounce]

Hi Renault.

We are not doctors on the forum - I think you need to talk to your doctor about this. I did have a Google for you and it came up with this.

Apixaban/Rivaroxaban/Edoxaban

You will need to stop taking these anticoagulants 1 or 2 days before surgery or a procedure. The doctor carrying out the surgery or procedure will inform you when it is safe to stop and restart them.

I think you need to talk to your medic about this one. Check with him / her for good advice. I hope your procedure goes well.

I'm sure it will and all the best with it.

Paul

[Renault4 in reply to Paulbounce]

Thank you so much for your reply.As you can imagine I'm pretty anxious about the balance of risks but am wafting for a call from the hospital to clarify all this.

[bantam12]

I was off Apixaban for 5 days but you should be given instructions before your procedure.

[Renault4 in reply to bantam12]

Many thanks that is reassuring.

[TracyAdmin Partner]

Thank you for your message, you should speak to the hospital where the procedure is being held, they will be able to advise whether your medication should be halted, if so how long for? They will be able to advise you personally, taking into account your condition, age and any other underlying risk factors. It is not recommended to stop any prescribed medication without prior medical advice.

[Renault4 in reply to TracyAdmin]

I am hoping to hear from the hospital to-day-I guess with all the backlog things are pretty pressing for them. Thank you too for your response.

[Trident3 in reply to Renault4]

Hi, I am taking Apixaban and have just in the last week undergone a colonoscopy. I was told by the dept performing the procedure to stop taking the Apixaban at least 3 days before (this transpires to be 72hrs) which like you I checked this site where the general consensus was 2 days. Checked with the dept who said that it used to be 2 days but was changed quite recently to 3 (5 for warfarin), and also stated that they perform this procedure of a lot of people with af. When completed they suggested restarting the Apixaban on the Sunday after having the procedure on the Thursday.

This was only my own personal experience and I am in no way suggesting that it is the definitive. I should also add that I suffered no noticeable bleeding or other effects that I am aware of.

Good Luck….. Alf

[JaneFinn]

Hi Renault Everyone’s advice to check with the hospital where it’s being done (which I see you’re doing) is good. It really does differ with different circumstances and for different risk factors. For instance, I was told by my GP I’d probably have to be off Apixaban for 3 days before, but when I spoke to the consultant doing the endoscopy he was much more relaxed about it. He knew exactly what he was planning to do (ie no biopsy) and that didn’t require me to be off Apixaban at all. Having a biopsy would be different obviously. So definitely go with the advice you’re given for your situation

Personally because I’m nervous of the potential risks of not being anticoagulated, I say this to the consultant before he makes his decision. I feel it helps them make a considered decision on my behalf!

Good luck, hope it goes well x

[rub123]

I had three biopsies taken in December I was advised to stop Apixaban forty eight hours before .The consultants secretary phoned and health centre phoned to tell me . I was fine and all was good . Hope this helps .

[Sebhel]

I’m A/fib on Apixaban + Bisoprolol 1.25

Hi, I had very similar experience! I spent a year with occasional light bleeding and had several endoscopies (which btw did not find anything) involving 24 hour Apixaban breaks. Then for 6 months National covid situation prevented appointments to address bleeding problem. My doctor panicked and got me into private hospital for free. They were excellent but pre Xmas postal problems lost my PCR test packets etc including pre op instructions! Last minute phone calls to receptionist further confused matters which ended up with instructions- 48 hour pre op. Followed by 48 hr post op medications stoppage. My MISTAKE was to ALSO to stop Bisoprolol 1.25 as well! (4 days)

I could not get through to GP for advice as covid situation blocked access to surgeries). Anyway I suffered sudden black out on 5th day and was taken by ambulance to hospital! Maybe black out wascaused by Bisoprolol stoppage! Now I know I definitely should not have stopped Bisoprolol - this mistake/misunderstanding was caused by communication issues / lockdowns

The GOOD NEWS is no more bleeding but now I’m having tests for black out incident

You must get through to and discuss/ confirm with doctors about dangers of stopping heartbeat medications

Best Wishes

[GrannyE in reply to Sebhel]

All that sounds so stressful. Bound to make the bp go up and the A/Fib worse. Rotten for you

[Denise-]

I had several biopsies last year and told not to take the morning tablet, when I had the surgery it was one the night before and the morning tablet. However ask the team your dealing with, also have a look at the NICE guidance.

Best of luck Denise

[Camelia23]

Hi Renault4 I recently had a sigmoidoscopy to remove a large polyp and take biopsy. I had to stop Apixaban for 72 hours before. This was on instructions of surgeon. I still had a bit of a bleed.

[Desanthony]

When I had mine they told me to be 24 hours free of apixaban. So took my last apixaban the Monday morning before the procedure and then nothing the Tuesday morning of the procedure. Had the procedure about mid morning. Best to ask the Dr doing the procedure as every hospital and every Dr has different ways of doing this. You should have a talk with nurse or Dr - maybe by phone a week or so before the procedure when they will tell you this - probably by phone these days and you should also get a pamphlet by post confirming all you have been told. Just make sure they know well in advance that you are on anticoagulants and any other medication you are on including over the counter meds as these can also make a difference to things.

[Elfiejean]

My cardiologist had me stop Xarelto 3 days before. He said if it was warfrin it would be 5 days. Had both upper and lower same day. I had no bleeding issues. They took 2 biopsies. Showed gastritis and nothing else. Wish you the best. I was sedated and remember nothing. Had no after effects. The prep was the worst part.