Table of Contents
I. There Are Risks to Surgery When You Take Eliquis
II. So, You Have to Prepare Properly if You Want to Go Through Surgery
III. But Remember That You Have Health-Care Professionals There to Help You
V. FAQ: How long before surgery should you stop taking Eliquis?
Thinking about undergoing surgery in the near future? If you also happen to take Eliquis, you may need a bit more preparation than most.
Eliquis is a blood thinner, which means it can increase the risk of bleeding during certain surgeries or invasive procedures. [1] That does not mean surgery is off the table, but it does mean you should speak with your healthcare provider ahead of time and follow their instructions on when to stop and restart your medication.
In this article, we’ll go over what to know about Eliquis and surgery, including possible risks, when Eliquis may need to be paused, and how to prepare before your procedure.
There Are Risks to Surgery When You Take Eliquis
First off, keep in mind that you’ll have a couple more risks to navigate than the average patient. So, you’ll want to prepare for them before undergoing surgery. Here are some possible risks to be aware of before your procedure.
Bleeding
The more common risk you might expect is easy bleeding. After all, as an anticoagulant, Eliquis thins your blood, making it harder for your blood to clot. This also makes it harder for your body to staunch any bleeding. But it is great at preventing harmful blood clot conditions, such as deep vein thrombosis or pulmonary embolism. [2]
However, this also means that Eliquis can increase bleeding risk during surgery. Because of this, your healthcare provider may give you specific instructions on when to stop and restart Eliquis. [1]
Of course, it depends on the type of surgery. If it’s a minor surgery, such as a dental procedure, the risk will be much smaller. However, if it’s a major surgery, such as a hip replacement, the risk will be greater. [1]
A Spinal Cord Blood Clot (In Some Cases)
In other cases, you could end up with a spinal cord blood clot. This can cause long-term paralysis. But it’s only likely to happen if you undergo a spinal tap or epidural while on Eliquis. [3] The following conditions could also increase its likelihood:
- Having an epidural catheter in place
- Taking other medications that affect bleeding or clotting, such as NSAIDs, platelet inhibitors, or other blood thinners
- Having a history of difficult, traumatic, or repeated epidural or spinal punctures
- Having a history of spinal deformity or spinal surgery [3]
So, You Have to Prepare Properly if You Want to Go Through Surgery
Now that you know the risks involved with surgery and Eliquis, you’ll want to minimize them. And you can do that by considering the following.
Write Down Questions to Ask Your Doctor
Your doctor will know a great deal about your condition and any associated risks. So, make use of this knowledge! Think up any questions that you feel would help you better prepare for your surgery.
To start, think of these questions:
- What should you expect during surgery?
- Will Eliquis affect it?
- Should you stop taking Eliquis before undergoing surgery?
- What can you do to minimize any risks during surgery?
Inform the Surgeon About Your Medical History
Once your doctor has been able to provide you with all the information you need, it’s time to consider your surgeon. It’s true that your doctor has probably shared your medical history with them. But you’re better safe than sorry. So, make sure you let your surgeon know about your Eliquis dose and anything else that you feel is relevant.
Depending on Your History, Your Surgery May Change Slightly
Once your surgeon knows your medical history, they may choose to change how they approach your surgery. For instance, how at-risk you are for thromboembolism (i.e., a blood clot forming within a blood vessel) could determine your Eliquis treatment plan during surgery. [4]
If You’re High-Risk, Timing Matters More Than Bridging
If you’re at high risk for thromboembolism, your surgical team will pay closer attention to the timing of your Eliquis interruption. Unlike older blood thinners such as warfarin, current guidelines generally do not recommend bridging therapy (temporarily switching to a short-acting injectable blood thinner) [5] for patients taking Eliquis, even those at high risk. Because Eliquis is cleared from the body relatively quickly, most patients can simply pause and resume it around the time of surgery under their surgeon's guidance, without bridging. [4]
If You’re Low-Risk, You May Be Able to Temporarily Stop Taking Eliquis
But if you’re unlikely to develop a thromboembolism, you may be asked to stop taking Eliquis temporarily. For surgeries with a high risk of bleeding, expect to stop your Eliquis dose 48 hours before the procedure. For low-risk surgeries, expect to stop your Eliquis dose just 24 hours before the procedure. As always, check with your physician too. [3]
But Remember That You Have Health-Care Professionals There to Help You
No matter how you and your surgeon prepare, it can always be a little nerve-wracking to undergo surgery. Eliquis can add extra complications to the procedure, too.
Regardless, you have a whole surgical team looking out for you. So don’t worry too much! Just make your concerns and medical history known. And in turn, the health-care professionals will do their best to keep you happy and healthy.
Conclusion
If you take Eliquis and have surgery or another procedure coming up, the most important thing is to plan ahead with your healthcare provider. Eliquis can increase bleeding risk, so your doctor or surgeon may give you specific instructions on when to stop it, whether any extra precautions are needed, and when it is safe to restart after the procedure. Always follow your provider’s instructions and do not stop taking Eliquis on your own.
Eliquis can also be expensive, especially for Americans paying out of pocket. Here at RxConnected, we can help you save hundreds of dollars a year on your Eliquis prescription by offering generic Eliquis. RxConnected sources medications from countries where generic Eliquis is already available, giving Americans access to a traditionally expensive medication at a more affordable price.
FAQ: How long before surgery should you stop taking Eliquis?
You usually need to stop Eliquis at least 24 to 48 hours before surgery or an invasive procedure, depending on the bleeding risk. Always follow your healthcare provider’s instructions, as they will determine the safest timing based on your procedure, bleeding risk, and risk of blood clots. For procedures with a moderate or high risk of serious bleeding, Eliquis is usually stopped at least 48 hours before. For procedures with a low risk of bleeding, or where bleeding would be easy to control, Eliquis is usually stopped at least 24 hours before.
Bridging anticoagulation, meaning temporarily using another blood thinner after stopping Eliquis, is not generally required during the 24 to 48 hours before the procedure. Eliquis is usually restarted after surgery once adequate hemostasis has been established, which means bleeding is controlled. Your provider should tell you exactly when to stop and restart Eliquis, so do not make changes to your dose on your own.
To prepare for surgery while taking Eliquis:
- Tell your doctor, dentist, or surgeon that you take Eliquis before any procedure.
- Confirm when to take your last dose before surgery.
- Do not use another blood thinner unless your doctor tells you to.
- Ask when it is safe to restart Eliquis after the procedure.
DISCLAIMER: The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis or treatment.