Changing from warfarin

[amy1808]

Hi guys , just wondering what blood thinners everyone is on? My GP has talked to me this morning regards changing from warfarin. This is only because of the battle I have had recently try to have surgery 🤦‍♀️absolute nightmare. Having biopsy on Friday then booking me in for surgery. The hospital has talked to the warfarin clinic pharmacist who has recommended stopping clopidogrel until after biopsy and make sure inr under 4. It’s been all over the place recently, stress I think . Tried to get hold of my specialist but no luck at MRI all the numbers have changed 🤷‍♀️. So if anyone on here under Martin Scott can I have his number please

😊

[MaryF Administrator]

Hi, your GP MUST talk to with your main Hughes Syndrome/APS specialist who in turn can talk to the Haematologist at your local hospital with regard to what their bridging plan is for patients with APS facing surgery, this would result in better care for you, do persist, and do come on here and chat to us again if you are feeling worried, sorry things are a bit tricky for you currently, hugs etc. MaryF

[Ozchick]

I've been on Clexane for a long while now and it's a lot easier to manage if you have to have surgery as it can be stopped/started by drip in Hospital-so easier to manage than Warfarin. As Mary has advised, talk to your main specialist for bridging or if you've had problems with INR's in the past look at changing thinners. As you've probably realised, no two meds work the same for different people! Good luck with your surgery!

[Thick_Blood]

LW Heparin 150mg a day. Love to be able to take a pill but I clot on everything else😢

[HollyHeski Administrator]

I'm on daily clexane, clopidogrel and aspirin, which does make bridging easier than warfarin.There are bridging plans in place for APS and warfarin, usually replacing the warfarin with heparin.

I would persevere with getting your plan from Dr Scott, the NHS will list him under the hospital and give a department number? (Is he under Manchester area? I googled and 3 tel nos came up in that area). You may get an email for his secretary from the hospital?

Pharmacist are brill advisors but I personally would be cautious with this, only your specialist should advise.

[Tucson]

I've been on Clexane since having a massive internal bleed 2 years ago. My specialist keeps trying to put me back on Warfarin but over my dead body. I never had any Inr issues on warfarin but had 2 further strokes and the bleed which very nearly bumped me off. I will fight to stay on Clexane.

[Ladydale]

I switched to edoxoban but was adviced to go back on warfrin as new research suggested that the newer blood thinners don't protect people with aps.

[Jumper99]

You will need to bridge, to some form of heparin probably, for your surgery. Your anticoagulation department should have procedure for this but only trust them if they are knowledgeable about APS. If not then double check with your APS consultant, this is not a decision for your GP. Warfarin is the recommended treatment for APS and DOACs are not as good for most people. Heparin (eg clexane or fragmin) works as well as warfarin for most people and clears your system much more quickly so they can take you off it for a very short space of time for the surgery. So it’s the safest thing to be on.

I recently had a tooth extraction and I had the same instructions as you for your biopsy. Stop clopidogrel and inr below 4. Clopidogrel apparently needs to be stopped 5 days before the procedure but this is being very very careful for only a small procedure like a tooth extraction.

My anticoagulation department were very helpful, I hope yours is too.

[Youmi111]

I’m not under that dr but when I had my ovaries out, the surgeon talked with my hematologist and discussed the plan. I still kept her paper with how she planned mine. I was having surgery on the 6th, so I had to stop warfarin on the 1st, started in evening on the 2nd with 90 mg lovenox shot. Had to do daily through the 4th. Then no shots or warfarin on the 5th or 6th (surgery date). Then 24 hrs after surgery-if no bleeding and surgeon oks it, I restarted warfarin 3 mg daily along with lovenox 90 mg shot daily. I had to do both until my INR reached 2.5 or higher then I stopped the shots and was just back to warfarin again. (Oh and I came through just fine- I had my last ovary and tubed removed) I hope all goes well for you. Wishing you a healthy and speedy recovery