{"id":628531,"date":"2024-06-09T20:23:37","date_gmt":"2024-06-10T00:23:37","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=628531"},"modified":"2025-03-18T11:00:04","modified_gmt":"2025-03-18T15:00:04","slug":"blood-thinner-before-surgery","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/blood-thinner-before-surgery\/","title":{"rendered":"Is it safe to stop blood thinners before surgery?"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Blood thinners are effective in reducing the risk of clots and heart attacks, but their use in a pre-surgery regimen is complicated. While <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/anticoagulants\"><span style=\"font-weight: 400;\">anticoagulants<\/span><\/a><span style=\"font-weight: 400;\"> like Warfarin, Eliquis, Xarelto, or aspirin might be necessary for people with certain heart conditions, surgeons might ask you to stop taking them before surgery. Why? We\u2019ve got the answers right here.\u00a0<\/span><\/p>\n<h2 id=\"should-you-stop-taking-blood-thinners-before-surgery\"><span style=\"font-weight: 400;\">Should you stop taking blood thinners before surgery?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Surgery comes with an inherent risk of blood loss, and blood thinners can make it more difficult to stop bleeding. So the question becomes: Should you stop taking blood thinners before surgery? In most cases, the answer is yes.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">But it\u2019s not as black and white as it might seem. \u201cThe decision to hold blood thinners involves a delicate risk-benefit analysis,\u201d says <\/span><span style=\"font-weight: 400;\">Dr. Taher Saifullah<\/span><span style=\"font-weight: 400;\">, founder of the Los Angeles-based <\/span><span style=\"font-weight: 400;\">Spine and Pain Institute<\/span><span style=\"font-weight: 400;\">. \u201cWhile excessive bleeding during surgery is a concern, we also need to consider the patient&#8217;s risk of blood clots. Stopping blood thinners can cause an increased risk of a deep vein thrombosis (<\/span><span style=\"font-weight: 400;\">DVT<\/span><span style=\"font-weight: 400;\">) in the legs or a pulmonary embolism, a blood clot that travels to the lungs.\u201d\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">While they might sometimes be a crucial part of the preparation, surgical procedure, and recovery process, doctors must be careful about preoperative <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/eliquis\/dosage\"><span style=\"font-weight: 400;\">blood thinner dosage<\/span><\/a><span style=\"font-weight: 400;\">. Per <a href=\"https:\/\/www.linkedin.com\/in\/tahersaifullahmd\/\">Dr. Saifullah<\/a>, \u201cIn complex cases, or for patients with specific medical conditions, consulting a hematologist is advisable to tailor the management of blood thinners before surgery.\u201d Doctors typically require patients to stop taking blood thinners at least 24 hours before surgery, and the exact timeline depends on the medication and procedure being performed. <\/span><a href=\"https:\/\/www.stoptheclot.org\/wp-content\/uploads\/2017\/11\/AC-Management-What-to-Expect-IPRO.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Per the National Blood Clot Alliance<\/span><\/a><span style=\"font-weight: 400;\">, here\u2019s when you\u2019ll typically need to stop taking certain common anticoagulant drugs:<\/span><\/p>\n<ul>\n<li><a href=\"https:\/\/www.singlecare.com\/prescription\/warfarin-sodium\/what-is\"><b>Warfarin<\/b><\/a><b>:<\/b><span style=\"font-weight: 400;\"> About 5 days before<\/span><\/li>\n<li><a href=\"https:\/\/www.singlecare.com\/prescription\/eliquis\"><b>Eliquis<\/b><\/a><b>, edoxaban, or <\/b><a href=\"https:\/\/www.singlecare.com\/prescription\/xarelto\/what-is\"><b>Xarelto<\/b><\/a><b>:<\/b><span style=\"font-weight: 400;\"> 2\u20133 days before (depending on kidney health)<\/span><\/li>\n<li><b>Dabigatran:<\/b><span style=\"font-weight: 400;\"> 3\u20135 days before (depending on kidney health)<\/span><\/li>\n<li><b>Aspirin: <\/b><span style=\"font-weight: 400;\">7\u201310 days before<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Failing to cease blood thinner treatment before surgery can increase the risk of excessive blood loss since the blood won\u2019t be able to coagulate during the procedure. This risk, however, can also depend on the specific operation. \u201cIf you are having a minor oral surgery, your surgeon may inform you that you don\u2019t need to avoid blood thinners at all,\u201d says Dr. Jerry Friedman, <\/span><a href=\"https:\/\/northjerseyoralsurgery.com\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">North Jersey Oral &amp; Maxillofacial Surgery<\/span><\/a><span style=\"font-weight: 400;\">. \u201cBut if you are having some kind of major bodily surgery, your surgeon may inform you that you need to stop taking blood thinners several weeks before the surgery.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Without these medications, some doctors may prescribe <\/span><a href=\"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/circulationaha.111.084517\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">bridge therapy<\/span><\/a><span style=\"font-weight: 400;\">. This involves administering a short-acting anticoagulant, such as heparin or low-molecular-weight heparin (LMWH), in the days before surgery.<\/span><\/p>\n<h3 id=\"what-if-you-need-surgery-while-on-blood-thinners\"><span style=\"font-weight: 400;\">What if you need surgery while on blood thinners?<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Sometimes, surgery is unavoidable, and if you\u2019re already taking blood thinners, you may just need to wait for them to leave your system. That time frame varies based on the drug. For example, the <\/span><a href=\"https:\/\/www.xarelto-us.com\/non-surgical-hospitalization\/faqs\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Xarelto website<\/span><\/a><span style=\"font-weight: 400;\"> says it will leave the body in around 24 hours, while <\/span><a href=\"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.CIR.101.10.1206\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">aspirin can take up to 10 days<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">But don\u2019t go based solely on information you find online. Rely on your physician\u2019s medical advice. \u201cWhen you have surgery scheduled, your doctor should discuss blood thinners with you ahead of time so that you know what you can and cannot take and when,\u201d says Dr. Friedman.<\/span><\/p>\n<h2 id=\"when-is-it-safe-to-take-blood-thinners-after-surgery\"><span style=\"font-weight: 400;\">When is it safe to take blood thinners after surgery?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">A <\/span><a href=\"https:\/\/archive.cdc.gov\/www_cdc_gov\/ncbddd\/dvt\/features\/accurate-reporting.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">CDC study reported<\/span><\/a><span style=\"font-weight: 400;\"> that approximately one out of every 100 patients developed a blood clot after surgery. That\u2019s why blood thinners are an important part of post-op recovery. However, the specific timeline varies based on the patient and type of surgery. \u201cThe surgeon will assess the surgical site for signs of ongoing bleeding before restarting blood thinners,\u201d says Dr. Saifullah. They \u201cmay use alternative pain management methods initially to avoid interfering with clotting while the surgical wound heals.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">According to a <\/span><a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1002\/lary.26991\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">literature review<\/span><\/a><span style=\"font-weight: 400;\">, as long as nothing happened during surgery that would increase the risk of bleeding, here\u2019s when patients can resume taking blood thinners:\u00a0<\/span><\/p>\n<ul>\n<li><b>Warfarin:<\/b><span style=\"font-weight: 400;\"> 12\u201324 hours after surgery<\/span><\/li>\n<li><b>Rivaroxaban, apixaban, and dabigatran: <\/b><span style=\"font-weight: 400;\">48\u201372 hours after surgery<\/span><\/li>\n<li><b>Aspirin: <\/b><span style=\"font-weight: 400;\">24 hours after surgery<\/span><\/li>\n<li><b>Clopidogrel: <\/b><span style=\"font-weight: 400;\">24 hours after surgery<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">The NIH says here\u2019s how long patients need to wait before resuming bridge treatment:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>LMWH or heparin for minor surgeries:<\/b><span style=\"font-weight: 400;\"> 24 hours after surgery\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>LMWH or heparin for major surgeries:<\/b><span style=\"font-weight: 400;\"> 48\u201372 hours after surgery\u00a0\u00a0<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Doctors don\u2019t prescribe blood thinners after all surgeries. In some cases, however, the doctor may require you to take them for <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC10332795\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">up to 35 days after the operation<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Blood thinners <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/eliquis-interactions\/\"><span style=\"font-weight: 400;\">may also interact with other drugs<\/span><\/a><span style=\"font-weight: 400;\">. These interactions include antifungals like fluconazole, heart medications like amiodarone, acetaminophen, ibuprofen, seizure medicines, and many different antibiotics. Let your healthcare provider know if you take any of these medications before surgery.\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Blood thinners are effective in reducing the risk of clots and heart attacks, but their use in a pre-surgery regimen is complicated. While anticoagulants like Warfarin, Eliquis, Xarelto, or aspirin might be necessary for people with certain heart conditions, surgeons might ask you to stop taking them before surgery. Why? We\u2019ve got the answers right [&hellip;]<\/p>\n","protected":false},"author":15,"featured_media":628532,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[9650,737],"coauthors":[8861],"class_list":["post-628531","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-blood-thinners","tag-heart-health","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Should you stop taking blood thinners before surgery? Learn what experts say<\/title>\n<meta name=\"description\" content=\"Get expert advice on the complexities of using blood thinners before surgery. 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