PATIENT INFORMATION
Blood thinners
“Blood thinner” can mean an anticoagulant such as warfarin, acenocoumarol, apixaban, rivaroxaban, dabigatran or edoxaban, or an antiplatelet medicine such as aspirin, clopidogrel, prasugrel or ticagrelor. These medicines cannot be managed safely with one universal stop date.
Why this needs a careful plan
These medicines prevent clots that can cause stroke, heart attack or blocked stents. They also increase bleeding during surgery. The team has to balance these two risks for your individual situation.
The decision depends on why you take the medicine, your risk of a clot or stroke, kidney function, the bleeding risk of the procedure, and whether spinal/epidural or another regional anaesthetic technique is planned.
What to tell the team
- The exact name, dose and timing of each blood thinner
- Why you take it (for example atrial fibrillation, a heart valve, a previous clot or a stent)
- The date of any coronary stent, and the type if known
- Who prescribed it and who monitors it
- Your recent INR results if you take warfarin or acenocoumarol
- All supplements and herbal products, including their ingredients and doses
Coronary stents
Patients with a recent coronary stent need particular care because stopping antiplatelet treatment too early can be dangerous. The surgical team may need to discuss timing with your cardiologist.
What the plan may include
A clear stop date, a restart date after surgery, a blood test before surgery, and occasionally a temporary alternative injection. Ask for these dates in writing.
Do not stop an anticoagulant or antiplatelet drug solely because of this website. Interrupting treatment can itself cause serious harm.