Stop Eliquis 2-5 Days Before Cataract Surgery (Consult Your Doctor)
Stopping Eliquis (apixaban) before cataract surgery depends on kidney function, bleeding risk, and procedure type. Most patients pause it 2-5 days pre-surgery, resuming 24-72 hours post-op if bleeding is controlled. Always follow your surgeon's or cardiologist's personalized advice to balance clot/stroke risks.
Key Factors Affecting Timing
- Kidney function: Severe impairment may require a longer pause (up to 5 days).
- Bleeding risk: Low-risk cataract surgery often needs only 48 hours off Eliquis.
- Stroke/clot history: High-risk patients may switch to a short-acting blood thinner (e.g., heparin).
- Surgeon's protocol: Some use local anesthesia with minimal sedation to reduce bleeding risks.
General Stopping Guidelines (Adults)
| Kidney Function | Standard Dose (5 mg 2x/day) | Reduced Dose (2.5 mg 2x/day) | Resume After Surgery |
|---|---|---|---|
| Normal | Stop 48 hours before | Stop 24-48 hours before | 24-72 hours post-op (if no bleeding) |
| Moderate impairment | Stop 72 hours before | Stop 48 hours before | 48-72 hours post-op |
| Severe impairment | Stop 96-120 hours before | Stop 72 hours before | 72+ hours post-op (monitored) |
Steps to Minimize Risks
- Pre-op: Confirm stopping time with your cardiologist and surgeon. Get blood tests (e.g., creatinine clearance) if kidney function is unclear.
- During pause: Watch for signs of clots (sudden numbness, chest pain, shortness of breath). Seek emergency care if they occur.
- Post-op: Resume Eliquis only after bleeding has stopped (usually 1-3 days). Use ice packs to reduce swelling/bleeding.
- Avoid: NSAIDs (ibuprofen, aspirin), alcohol, and strenuous activity for 1 week post-surgery.
Alternatives if High Stroke Risk
- Bridging therapy: Short-term low-molecular-weight heparin (LMWH) injections (e.g., enoxaparin) may be used.
- No interruption: Rarely, surgery proceeds without stopping Eliquis if stroke risk outweighs bleeding risk.
- Delayed surgery: If recent clot/stroke (<3 months), surgery may be postponed.
Warning Signs to Watch For
After stopping Eliquis:
- Red flags for clots: Sudden vision changes, slurred speech, leg pain/swelling.
- Red flags for bleeding: Excessive bruising, prolonged oozing from surgical site, blood in urine/stool.
Contact your doctor immediately if any occur.