{"id":628619,"date":"2024-06-17T10:31:00","date_gmt":"2024-06-17T14:31:00","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=628619"},"modified":"2026-01-30T11:19:26","modified_gmt":"2026-01-30T16:19:26","slug":"eliquis-before-surgery","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/eliquis-before-surgery\/","title":{"rendered":"How long should you stop Eliquis before surgery?"},"content":{"rendered":"

Eliquis, the brand name of the generic medication apixaban, is an <\/span>oral anticoagulant<\/span><\/a> and <\/span>Factor Xa inhibitor<\/span><\/a> medication that reduces the risk of a blood clot. Since apixaban will not be <\/span>available until 2028<\/span><\/a>, Eliquis is the go-to prescription.\u00a0<\/span><\/p>\n

Manufactured by Bristol-Myers Squibb, Eliquis is a medical treatment for people with serious conditions such as atrial fibrillation, pulmonary embolism, or deep vein thrombosis (a blood clot in the legs).<\/span><\/p>\n

Taking Eliquis in a perioperative period can be high-risk, though. \u201cWhile its use is necessary for a variety of conditions, such as atrial fibrillation or a deep vein thrombosis (<\/span>DVT<\/span><\/a>), taking this drug can lead to severe, even life-threatening bleeding if used in the preoperative period,\u201d warns <\/span>Dr. Kofi Quaye<\/span>, a vascular surgeon at <\/span>Cardiothoracic and Vascular Surgeons<\/span>.\u00a0<\/span><\/p>\n

Due to Eliquis’s effect on blood clotting, stopping it before surgery is crucial to minimize bleeding risks. Continue reading to learn crucial information for anyone taking Eliquis who requires surgery.<\/span><\/p>\n\t\t

\n\t\t\t

Save up to 80% on Eliquis with SingleCare<\/p>\n\t\t\t

Different pharmacies offer different prices for the same medication. SingleCare helps find the best price for you.<\/p>\n\t\t\t

\n\t\t\t\t
\n\t\t\t\t\tEliquis 5 mg (28 Tablets)\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\t23666 - Hampton, VA\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t
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\n\t\t\t\"Kroger\t\t\t<\/div>\n\t\t\t
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\n\t\t\t\t\t$155.92\n\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\ti<\/span>\n\t\t\t\t\tPrice with signup<\/a>\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t
\n\t\t\t\tGet free coupon<\/a>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\"Harris\t\t\t<\/div>\n\t\t\t
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\n\t\t\t\t\t$155.92\n\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\ti<\/span>\n\t\t\t\t\tPrice with signup<\/a>\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t
\n\t\t\t\tGet free coupon<\/a>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\tSee Eliquis prices at all pharmacies<\/a>\n\t\t<\/div>\n\n\t\t\n

How long should you stop Eliquis before surgery?<\/span><\/h2>\n

With a <\/span>half-life of about 12 hours<\/span><\/a>, patients don\u2019t have to go long without their Eliquis dose before surgery. Not stopping it <\/span>too<\/span><\/i> early is crucial because premature discontinuation can increase the risk of thrombotic events.<\/span><\/p>\n

According to <\/span>Dr. Andrew Shapiro<\/span><\/a>, medical director of <\/span>Advanced Surgical Physicians<\/span><\/a> and a fellow of the American College of Surgeons, stopping Eliquis before surgery is crucial. He states Eliquis is a blood thinner that “inhibits clotting, potentially complicating surgical bleeding control.”<\/span><\/p>\n

\u201cMost patients will be able to hold their Eliquis for a few days, two to three, before surgery,\u201d Dr. Shapiro says. \u201cDepending on the reason for Eliquis, some patients may be placed on a short-acting, injectable medication while Eliquis is being held before surgery.\u201d<\/span><\/p>\n

Dr. Shapiro adds that when undergoing major surgeries, back surgery is an instance in which patients may have to take their last <\/span>dose of Eliquis<\/span><\/a> as many as four to five days prior, noting that some physicians require even longer.<\/span><\/p>\n

Dr. Alexandra Kharazi<\/span><\/a>, a cardiothoracic surgeon at Southern California Surgical, has a similar estimate of around 48 hours.<\/span><\/p>\n

Ultimately, the timing depends on the type of surgery. Major surgeries\u2014like abdominal or orthopedic ones\u2014are usually the ones that require 48 hours, Dr. Quaye<\/a> says. \u201cSome minor surgeries (such as a lipoma removal or those with low risk of bleeding) can sometimes be held 24 hours before,\u201d he continues. \u201cThese are, however, surgeon-specific and will be articulated by your physician.\u201d<\/span><\/p>\n

While stopping Eliquis before surgery is necessary, it does come with risks (that aren\u2019t necessarily dire). Some of those pertain to why the person was put on the medication in the first place. \u201cFor example, if you are prescribed Eliquis in the setting of <\/span>atrial fibrillation<\/span><\/a>, this may expose you to a higher stroke risk during the period it is held,\u201d Dr. Kharazi says. \u201cHowever, if held for a short period and resumed after surgery, the risk is not major.\u201d<\/span><\/p>\n

Dr. Quaye adds that the risk varies depending on the situation and condition Eliquis is treating. To be prepared, it\u2019s best to talk to the surgical team about the individualized size of that risk.<\/span><\/p>\n

RELATED: <\/b>Eliquis side effects and how to avoid them<\/b><\/a><\/p>\n

When to restart Eliquis after surgery?<\/span><\/h2>\n

According to Dr. Shapiro, Eliquis is typically resumed the day after surgery if there\u2019s been no or minimal bleeding during the procedure. \u201cIf there has been a more involved or complicated procedure with a larger amount of blood loss, the Eliquis might be held for a longer period to minimize the risk of postoperative bleeding,\u201d he continues. \u201cThis decision is managed against the risk of blood clot formation while off Eliquis.\u201d<\/span><\/p>\n

Dr. Kharazi agrees that getting back on Eliquis is safe once there are no signs of postoperative bleeding. In some cases, she says, this is around the 24- to 48-hour mark.<\/span><\/p>\n

A review<\/span> in <\/span>The Laryngoscope<\/span><\/i><\/a> leans more toward the conservative end, suggesting patients resume apixaban two to three days after surgery. It clarifies that warfarin is a blood-thinning medication that can be resumed in 12 to 24 hours.<\/span><\/p>\n

However, every surgery and individual is different. Another factor that may be considered is if postoperative procedures are needed. \u201cFor example, in the case of open heart surgery, we may need to do minor procedures in the postoperative,\u201d Dr. Kharazi says. \u201cInstead of resuming Eliquis, a heparin drip is a better idea because it has a shorter half-life and can be held six hours before the procedure.\u201d<\/span><\/p>\n

Before restarting Eliquis, it\u2019s important to be aware that some post-surgery drugs may interact with it, making it more or less effective, Dr. Shapiro says. One example he lists is non-steroidal anti-inflammatory drugs (<\/span>NSAIDs<\/span><\/a>), such as ibuprofen, aspirin, and celecoxib, used for pain. Others include antibiotics, such as clarithromycin.\u00a0<\/span><\/p>\n

According to Dr. Quaye, clarithromycin is an antibiotic that \u201cmay enhance the anticoagulant effect of Eliquis by inhibiting some of the enzymes in the liver, which helps clear Eliquis from the blood.\u201d This is because Eliquis is cleared from the body through the liver. \u201cPatients with liver disease are at an increased risk of bleeding since Eliquis will stay in their system longer before it is fully excreted,\u201d he adds.<\/span><\/p>\n

Additional <\/span>Eliquis interactions to avoid<\/span><\/a> include other <\/span>anti-clotting medications<\/span><\/a> (such as warfarin), selective serotonin reuptake inhibitors (<\/span>SSRIs<\/span><\/a>) and serotonin-norepinephrine reuptake inhibitors (<\/span>SNRIs<\/span><\/a>), inhibitors and inducers of CYP3A4, and grapefruit and grapefruit juice.<\/span><\/p>\n

With some seemingly random contradictions, patients may worry they\u2019ll accidentally ingest something they shouldn\u2019t. Rest assured, patients aren\u2019t expected to know everything that is and isn\u2019t safe to take with Eliquis without medical advice. \u201cYour pharmacist should be able to reconcile your medications and ensure that there are no interactions, as well as make the necessary adjustments,\u201d Dr. Kharazi says.\u00a0<\/span><\/p>\n

Dr. Shapiro says patients should inform their healthcare provider and pharmacist of all the other medications they’re taking including prescription, over-the-counter, supplements, and herbal medications<\/span><\/p>\n

For more information on Eliquis, check out this <\/span>medical guide and fact sheet<\/span><\/a> by Bristol-Myers Squibb. When refilling a prescription of Eliquis, remember to use a SingleCare <\/span>prescription discount card<\/span><\/a> to save up to 80% of the cost.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Eliquis, the brand name of the generic medication apixaban, is an oral anticoagulant and Factor Xa inhibitor medication that reduces the risk of a blood clot. Since apixaban will not be available until 2028, Eliquis is the go-to prescription.\u00a0 Manufactured by Bristol-Myers Squibb, Eliquis is a medical treatment for people with serious conditions such as […]<\/p>\n","protected":false},"author":133,"featured_media":628620,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[9650,788],"coauthors":[21001],"class_list":["post-628619","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-blood-thinners","tag-drug-safety","wpautop"],"acf":[],"yoast_head":"\nHow long do you hold off taking Eliquis before surgery?<\/title>\n<meta name=\"description\" content=\"Eliquis should be stopped between two and five days before surgery. 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