Ceasing Apixaban

[johnkeithdowning]

I am due for knee joint replacement surgery. Can anyone relate their experience with stopping and starting Apixaban before and after the operation. I also take Ramipril, will I need to stop this for a while?. Thanks

[CDreamer]

I don’t think I have ever stopped or even if there is a need to stop. Have you been told by the hospital? If you have had no instructions then I would ring, ask and check that they know you take it. I’ve had a few procedures and been told just not taken my morning dose. That it one of the advantages of Apixaban - short half life so no need to stop for procedures.

[BenHall1]

I understand your question re Apixaban .... but are you questioning stopping Ramipril too ... may have misunderstood your wording. Never used Apixaban, only Warfarin and had to stop 6 days before knee replacement ...... not a worry in the world. As soon as I was returned to my room, a nurse administered 2 injections of a bridging anticoagulant ( Fragmin ). Later that evening I returned to my normal dose of Warfarin. I never stopped Ramipril or any other drugs I had been prescribed.

You would be far better occupied concentrating on pain control. If you don't control pain your ability to carry out all the exercises necessary to enable full movement to be restored will be limited. I also opted for massage therapy from a sports injury massage therapist on the incision line and the surrounding area. The objective is to prevent scar tissue forming inside the incision area.

[johnkeithdowning in reply to BenHall1]

Thank you. V useful response

[Desanthony]

At your pre-op assessment they will tell you when and if you have to stop any medication. Make sure you tell them all the medication and over the counter supplements you are on as some supplements can have an effect on medication they want to give you. I always take a nicely typed out list of all my medications with me so that I don't forget any. My wife was a PA so is good at that sort of thing. She types up a table showing the name of the tablet, dosage and number of times taken a day and time taken. She makes copies and I hand them to all the medical professionals I come into contact with - sister in charge of the ward, surgeon anaesthetist and also keep one on the table beside my bed when in hospital.

I had to stop my Apixaban 3 days prior to my total knee replacement back in 2019. I was then put back on half dose for a month. They usually use a different anticoagulant during the operation if necessary so once they know the effect of that has worn off they put you back on your usual anticoagulant. I had no problems at all and stayed in NSR all the way through the experience as I had had a Cardioversion about 8 weeks before the operation. The worst part was that they forgot to give me the half dose tablets at the hospital before I left and my pharmacy couldn't get them (I was dishcharged early Saturday morning, so we had a few days of cutting little tablets in half before they hospital package arrived via post!

All the best my advice on recovery from your knee replacement is to take your full dosage of painkillers on the dot every day and 20 mins later when they should have taken effect do your exercises. Do your exercises religiously and as many times as you can. this is actually a time when the old saying no pain no gain works.

I am so pleased I had my op - and I was dreading it but I can no kneel down in the garden to do weeding - something they told me I would never be able to do again even with the knee replacement.

Good Luck.

[johnkeithdowning in reply to Desanthony]

Thank you

[BenHall1 in reply to Desanthony]

Hi Desanthony,

Your last bit about kneeling down ........... same applies to me. If our cat rolls one of its toys under our sofa/lounge, I can barely get down to kneel .... manage it, but is quite stressful and perhaps in an odd way painful. Like kneel on very rough sand between the knee joints. I am now 8 years since surgery.

Also, totally agree with what you said about taking painkillers.

John

[Desanthony in reply to BenHall1]

It is quite stressful. I am just so pleased that my surgeon did such a good job and now I ca kneel without pain. got to say I don't do it very often but so pleased when I found I could do it. I still have a couple of those grabbing sticks as I thought i would need them forever but my wife now uses them more than I ever did for reaching up to get things off the shelves in the garage! As I get older I am sure I am more likely to need these sort of aids.

Keep taking the tablets! Keep Exercising! Keep going on! Once you stop you're done for.

[Peony4575]

Good luck with op. Husband had hip replacement and someone advised us to pay for hydrotherapy, private service run by physios at our local hospital in the evening . So the physio had him doing exercises in the water and it was a great help . I was amazed how quickly he was back to walking without a stick he went back to work after 6 weeks . I think knee recovery is harder work than hips but worth the effort. Good luck

[johnkeithdowning in reply to Peony4575]

Thank you

[Bingofox007]

I’m waiting to have other knee replaced, left done in 2018 but due to pain in right haven’t had full benefit from it. I didn’t have PAF then so wasn’t on edoxaban, I remember subcutaneous injections in abdomen after for a while for anticoagulation. I will wait for instructions from pre-op assessment regarding any need to stop meds before surgery. I agree with others here tho, don’t decline painkillers in hosp and take regularly when home, along with something to help bowels as the analgesia can be a bit constipating. Do you exercises for sure. I liken it to childbirth…you have to forget what it was like before planing to give birth again, it’s been 6 yrs since last knee replacement and I’m ready have the surgery again, on reflection 31 yrs since childbirth and that still haunts me, lol. Good luck and take care 🦊x

[johnkeithdowning in reply to Bingofox007]

Thanks for your honest response. I have heard from other sources that keeping up with exercises and pain meds is of utmost importance. Not sure I can relate to the pain of childbirth but I won't be watching Call The Midwife until after the op....LOLThanks again

[Bingofox007]

you’re welcome. Ironically when I got home from hospital following the op there was a series on late showing surgical procedures and it happened to be a knee replacement. I didn’t watch it! lol 🦊x

[mhoam]

John,

Sadly, I’ve had surgery a few times since starting on Apixaban. On each occasion the pre-op assessment has given “advice” on when to stop the anti-coagulant. I have always followed the advice as some surgeons will not proceed if you haven’t.

As stated elsewhere, they will normally give another injection during your stay to reduce the risk of clots. When discharged they should give clear guidance on when to re-start your normal dosage, if they don’t then you should ask.

Lots of people on Apixaban and other anti-coagulates so this is standard procedure for them

Good luck

[johnkeithdowning in reply to mhoam]

Thanks

[Karendeena]

My brother had a bladder tumour removed and had to stop apixaban 3 days before. He didn't resume them until he came out of hospital 5 days after. My brother had previous strokes but didn't suffer any ill effects after stopping apixaban

[johnkeithdowning in reply to Karendeena]

Thank you. It seems that stopping Apixaban 3 days before op is the norm

[Auriculaire]

I'vd had both hips replaced and had to stop Apixaban before. The last time for 3 days. I was started back on it the day after my op.

[SuziElley]

I had a total knee replacement two years ago and had to stop Apixaban 48hours before surgery, then restarted the day following. Your surgeon will guide you about restarting. Your preop assessment will give you details of when to take and when not to take all your medications. All the best

[johnkeithdowning]

Thank you

[exmouth]

Hi John I had a new knee two years today I didn’t have any problems I’m also on Apixaban I just stopped taking it when they said and after the op I just started taking it as usual. Hope it goes well Take care.

[dixiedad]

I had to stop Apixaban 5 days before abdominal surgery and 3 days after. I had no problem.

[Usta]

For my right knee TKR( totalknee replacement) and dental implant procedures, I was advised to stop apixaban 3 days prior for the knee and 2 days prior for the implant. For the TKR, cardiologist advised when to restart and for the dental, the cardiologist said to follow the dentists advice. My guess is the restart depended on getting any residual bleeding stopped. Best of luck with your knee replacement and recovery. I bicycle, walk, play doubles tennis, etc. Much better...pain free!

[johnkeithdowning in reply to Usta]

Thank you. Pleased to here yours was a success

[TracyAdmin Partner]

Hello

You must check with the medical team carrying out the procedure, they will advise on the most appropriate action to follow, we would not encourage halting or pausing a medication without prior medical consent.

Kind regards

TracyAdmin

[johnkeithdowning]

Thanks to everyone who responded. Excellent info

[Sally_Scott]

I recently had surgery. I had to come off apixaban for 3 days prior. I was given injections to administer myself in my tummy for 3 days instead of apixaban. It was a thinner.

[johnkeithdowning in reply to Sally_Scott]

Thanks Sally_Scott