re stopping Eliquis prior to surgery

I always thought that the only danger of stopping Eliquis prior to surgery is because one might get AF while off it and that could cause a stroke. However I just read online that iust stopping it can bring on a stroke! Is this true?

I haven't seen what you are referring to. Can you find it and post a link?

My understanding is that a DOAC is meant to reduce the risk to something reasonable if you are fibrillating, or if you have been fibrillating for more than about 24-38 hours and are now in apparent NSR (normal sinus rhythm). The risk is for a potentially dislodged clot issuing from the left atrial appendage (LAA). The risk persists for some weeks after the last fibrillation. Stopping suddenly, as in not taking the next dose, should present no risk of AF at all unless you are entering persistent AF and are in AF about 50% of the time or more. Even so, it's not the apixaban or rivaroxaban, it's just a wonky heart. You can, as far as I know, stop taking a DOAC tonight. All you incur is a risk of a stroke if a clot dislodges, and that risk will rise with each hour past the 12 hour half-life mark.

AI Overview
Yes, stopping Eliquis can increase your risk of a blood clot forming, which could lead to a pulmonary embolism or stroke. Do not stop taking it without first consulting the prescribing healthcare provider, who may suggest an alternative anticoagulant to bridge the gap and cover this risk.
Key points to remember
Increased risk of clots: Discontinuing Eliquis prematurely significantly raises the risk of thrombotic events, such as stroke or pulmonary embolism.
Underlying reason: The risk of a clot exists because of the condition that initially required the medication (like atrial fibrillation).
Need for alternatives: If you must stop taking Eliquis for a medical procedure or other reason, your healthcare provider will strongly consider prescribing another anticoagulant for coverage.
Never stop on your own: Always talk to your doctor before stopping Eliquis, as even a single missed dose can increase your risk of clotting.

Eliquis website:

[www.eliquis.bmscustomerconnect.com]

Do not stop taking ELIQUIS without talking to the healthcare provider who prescribed it to you.

Stopping ELIQUIS increases your risk of having a stroke.
Talk to your healthcare provider before any surgery, medical, or dental procedures. Learn more below.

Do not stop taking ELIQUIS without talking to the healthcare provider who prescribed it to you.

Stopping ELIQUIS increases your risk of having a stroke.


Talk to your healthcare team before any medical procedures. ELIQUIS may need to be stopped before surgery or a medical or dental procedure. Your healthcare provider will tell you when you should stop taking ELIQUIS and when you may start taking it again. If you have to stop taking ELIQUIS, your healthcare provider may prescribe another medicine to help prevent a blood clot from forming.

thnx to both of you. I have had to stop Eliquis for other procedures but thankfully not had any issues. Its so frightening, never realized that stopping it could cause a stroke even without having AF episode I don't think for a dental extraction there would be any alternative as any other anticoagulant would be just as bad as Eliquis for a surgery. I am waiting to hear back from cardiologist office altho dental surgeon suggested stopping 2 days prior to surgery and that is what cardiologist has recommended prior to other surgeries.

I have stopped Eliquis on direction for three events, all three being catheterizations (one angiogram first, then two ablations). In each case I was to take up to five (5) 'baby' aspirin over the next 12 hours, and they gave me both Plavix, a single tablet, and......AND......used heparin just after I got into the cath lab. This was for the angiogram...no heparin for the two ablations.

So, the upshot is, yes, ceasing one's prescription of a DOAC might/probably will raise the risk of stroke over the next 12 to 24 hours, and beyond, but only if the reason for the prescription is still in play (risk of stroke from clotting). If somehow one's risk of a stroke from clotting could be reduced to near-zero inside of a few hours, and we were NOT taking into account the risk of an unsealed LAA because it, too, is not a factor, then you CAN stop taking a DOAC. It's not like metoprolol or some other medications where you need to be weaned off it over a couple of weeks (amiodarone, as an example). But for we AF sufferers who have that risk of a clot, even weeks after a successful ablation, we only raise our risk of a stroke if we stop following the prescription of the DOAC, cold turkey or slowly doesn't matter. The risk goes up as the circulating drug falls due to liver metabolism.

Here is my interpretation of what gloaming says. My understanding is that stopping Eliquis removes its protection against strokes. This is obviously an issue if you have a high risk for strokes. I'm not aware of any data that stopping Eliquis increases your risk above what it would be if you weren't taking Eliquis.

Said much more succinctly, George. Thank-you.

thnx so much for everyone's input, thnx George for elaborating, feeling a little less frightened. anneh

I think for malpractice reasons, Eliquis has to legal up and write openly about a clot risk…not that they may think it will happen, they just had to legally write a disclaimer which probably has scared a few people.

I’m sure everyone has forgotten a dose or two and were ok.

Myself, I have a watchman but still my hematologist is very serious about me not skipping an Eliquis dose because of my history of two DVT clots…the last while I was religiously taking 2.5mg BID without forgetting a dose and still got a DVT clot. But two times since I had to stop temporarily for surgeries for 3 days.

I was required to stop Eliquis for an Endodontic dental procedure so my Cardiologist and dental team worked up a replacement regimen of me starting heparin injections 2 days prior to the procedure and the dentist not using epinepehrine with his local anasthetic during the procedure.

No one involved was particularly happy with the compromise; the dentist as he had more blood in the work area than he would have had with the epinephrine, the Cardiologist as I was giving up some of the Eliquis protection, and me because there was more pain involved since einepherine was not used.

It had a happy ending in that the tooth was successfully treated and I had no negative effects.

My mother's GI doctor stopped Coumadin before an endoscopy and 5 days later she had a stroke. There was no heparin bridge and I still don't know whether a doctor put her back on the Coumadin after the surgery. I do know that once in the hospital it took a long time for her INR to go back up so a bridge was needed, but not done.