Stopping Apixaban

[AstroFish]

I’m having a partial knee replacement this coming Friday and I’ve been asked to stop taking my Apixaban 48 hours prior to the op.

I didn’t have my dose this morning and I didn’t expect to feel so at sea! I have come to gain a certain reassurance about its protective benefits and I feel most lost and vulnerable without it!

Is this a usual feeling? I have been on it since 2020 and had no bad experiences.

I'm not sure when I’ll be able to recommence - they haven’t told me that yet! Any ideas anyone?

[BobD Volunteer]

Realistically you have no choice so best accept things and move on. Your profile suggest that your AF is rare so the chances of anything bad happening would seem very low. I'd be far more worried about recovring from the surgery. I would expect you to be able to start again quite soon after the operation but of course you will get guidance.

[FraserB]

I take apixaban and had total knee replacement surgery last November. I also felt vulnerable those hours off of it -- a completely normal feeling, but be assured your doctor knows your medical profile and they take every precaution to make sure you're not at risk for either clots or bleeding both before, during and after your surgery and most importantly into your recovery. I also had the pre-op nurse second the same when I talked with her.

[BenHall1]

I had a partial done in Nov 2015, I was ( and still am on Warfarin ). I was told to stop Warfarin 6 days before, which I did. I self test my INR. Got to hospital checked in, prepped for surgery, surgeon and anethetist called in and I showed them on my Coaguchek device what my INR readings were and they were happy and chuffed off.

After surgery, back in my room when I'd fully 'come round', a nurse came calling and gave me two Fragmin injections and that evening I was told to return to Warfarin as normal. Then carry on forever as normal with Warfarin.

Sorted. What's not to like. No problems, no issues ... no nothing - discharged 3 days later back home.

You would be very well advised - very well indeed - to focus your mental energies on the recovery process and the exercises you'll HAVE TO DO !!

[DawnTX]

it’s common to be asked to stop taking it with any type of procedure surgery. You need to do what? the doctor tells you

When I had I would be stopped from taking it for up to three days each one was different when I got my pacemaker and node done they didn’t take me off. It must have something to do with the odds of bleeding or what you may have had previously. They actually have it noted in my chart that I had lost less than a teaspoon of blood. They have reasons for different ways of doing this please don’t mess around with it. I love well, but I’m not a doctor if the doctor says, don’t take it then I won’t. It’s not for long. Each time I have been in the hospital once I am in my room. My nurse usually comes to me and gives me medication that I had missed. Best of luck with the knee. .

[Normynoo]

I had a hip replacement in August last year had to stop Edoxaban for 2 days before after the op had fragmin injections for 10 days then restarted the Edoxaban.Each surgeon seems to have a different regime but they know what they're doing.Good luck with the op ☺️

[Silvasava]

Had major colon surgery last year, stopped Edoxaban 3 days prior to op, was back on it the day after surgery. Just make sure you get up and move after the operation if you are able

[Nimitz68]

I had an operation to remove a lump on the outside of my chest cage three weeks ago. Was told to stop the apixaban two days before, which I did. No ill effects and was told to restart it, taking evening dose that evening.

[SuziElley]

I started mine again the day after surgery. The main thing with knee replacement is to do your exercises religiously! Two or three times a day, every day. Yes it might hurt but the benefits are more than worth the effort. All the best

[oscarfox49]

It depends on your risk profile in stopping apixaban, something which concerns me intensely as I have already had a serious stroke from the effects of AF when I wasn't taking it.

Many minor operations particularly in France are carried out with just a local anaesthetic or epidural, but the apixaban would considerably elevate the increase of bleeding into the spinal cord from this.

But it is almost impossible to calculate the increased risk of stroke from the abrupt cessation of apixaban before the medical procedure, especially with a very heightened level of anxiety and permanent AF. I have read this also a rebound effect when you stop apixaban which means blood clotting is more likely to occur.

Of course, I assume the medical fraternity is aware of such risks but I have been postponing the necessary operation required for a fairly serious inguinal hernia for almost a year due to my anxieties on this.

It is interesting to see how others cope with such concerns but I understand once you have had one stroke another is far more likely if you have to stop anticoagulant medication.

[AstroFish]

Thanks everyone for your replies. The answer for me today ( following surgery) was an anti coagulation jab and re start Apixaban in the morning but half my usual dose as this is what they do here following knee surgery. After two weeks I resume on my usual 5mg per dose.