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Old 13th May 2016, 09:27
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Radgirl
 
Join Date: Jul 2013
Location: Kiwiland
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Really good points Uplifting

If you need any operation where there is a risk of bleeding you should consider coming off anticoagulants and we would normally 'bridge' with heparin injections. With warfarin I would stop say 5 days before and demand MORE blood tests to check the INR is back down. With the newer drugs we stop at the same time but no tests

We can reverse warfarin with vitamin K and it is pretty good in an emergency. The good news is that we now have idarucizumab, a monoclonal antibody that reverses the newer anticoagulant dabigatran. Dabigatran can also be removed from the body by dialysis in an emergency. Idarucizumab is not yet freely available in the UK, but this will likely change very quickly and we can get hold of it in a hospital setting within an hour.

We await news of Andexanet Alfa - my understanding is that all these reversals are being fast tracked

However, in studies the newer anticoagulants have been shown to produce less nasties such as strokes and bleeding, although perhaps more common, is not so severe as with warfarin.
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