Rivaraxiban (update)

[Kittyca]

Hello, I have decided to share the answer I received from hospital after my appendicitis operation. It might be good to know:

‘Our current guidance for patients taking Rivaroxaban very much depends on the setting of the surgery, either being minor or major surgery and elective or emergency surgery.If kidney function is normal and the procedure is a low bleeding risk, Rivaroxaban should be stopped 24-hours before surgery, with high bleeding risk procedures it should be stopped 48-hours before. It can be restarted after the bleeding risk is has returned to normal, normally after 48-hours.There is a reversal agent for Rivaroxaban, it is called Adexanet but we don't stock it because its not licensed. It is only in emergent and life threatening situations that patients will be operated on whilst on anticoagulation, otherwise they are managed medically until the NOAC wears off.’

[seniorita]

Thanks, Kittyca, for posting this. My feeling is that they thrust these things on us, and are not totally honest . I was told to take Rivaroxaban, I still am not convinced I need it as in my hospital notes it says I'm "a bit of a bleeder." I was in a state of shock when this was prescribed after the preceding 10 days of hesrt related events, and feeling very vulnerable. I only took it as I was told it's easily reversible, which apparently it isn't as I recently found out there is no antidote, and now your info on a reversal agent.My other concern is that it appears to have the opposite effect to the one intended, that is I don't bleed, even with a dental extraction. I reported this numerous times, one pharmacist looked into this, there is no blood test to see how effective it is, only to measure how much is in your blood. Not a happy bunny.

[Ppiman]

Are you in the UK? If so, have you read this? It will bring comfort.

gov.uk/drug-safety-update/d...

Steve

[Tapanac]

I am on apixaban snd recently I had a very bad fall causing a brain bleed. I was given the reversal drug which many times I have read on here that there isn’t one. All the best

Pat

[Singwell]

That IS helpful to know. Thank you for posting.

[mjames1]

Thanks for the update. What struck me is that this hospital does not stock the reversal agent for Rivaroxaban. I don't know how widespread this is in the UK, but I think which hospitals stock which reversal agents, would affect my choice of both AC's and/or hospitals. When I was on Rivaroxaban, my doctor's in the US told me reversal agents were available.

Jim

[JOY2THEWORLD49]

HiNot NZ's guidance.

I have had 2 operations since AF diagnosed.

3 days clear before operation day, day and 2-3 clear days after. 24 hr = clear.

I'm on PRADAXA 150mg for 1st operation Thyroidectomy with 12 Lymphs removed and 110 mg PRADAXA - both twice a day for a TVT Kit (Johnson & Johnson) Mesh removal - 1 hour long.

But when my 83 year girlfriend had skin lesions excised 5 she was left on Pradaxa 110mg x twice day. Some bleeding.

RADCLIFFES Medical state that anti-coagulants should be used with more concern. The less dosage or at all should be weighed up.

PIP Pill in pocket for those with out persistent AF. Have it when in AF only.

I have persistent so PIP would be out for me but to me it sounds obviously best for other patients.

On the Forum recently an Ablation taking 6 hrs -- changing hands during the patient ended up having a stroke. Sedation only.

Unfortunately it is a risk for all operations.

Both my surgeons reminded me of a risk of bleeding. PRADAXA has a readily available antiDote. Also twice a day reduces its potentcy having the operation - both at 1pm.

cheers JOY. 73. (NZ)