Medications
Apixaban (Eliquis) Before Surgery
Apixaban is a direct oral anticoagulant (DOAC). It clears the body faster than warfarin, so the stop time is shorter. But it depends on your kidneys and the surgery.
Quick answer
Why it matters
Apixaban blocks clotting factor Xa and wears off in a day or two, so a short, well-timed pause usually gives safe surgery without leaving you unprotected for long.
Because the drug is partly cleared by the kidneys, reduced kidney function means it lingers longer. So your exact stop time depends on your kidney blood test and how much bleeding the surgery involves.
Do not stop without instruction
What to ask your doctor
- Exactly how many hours before surgery do I stop apixaban?
- What is my kidney function, and does it change the timing?
- When do I restart it afterward?
- Do I need any bridging (usually not)?
Red flags, call your team
Red flags, call your team
- Kidney disease or reduced kidney function
- A previous blood clot, stroke, or mechanical valve
- Unusual bleeding before surgery
References
- American Society of Regional Anesthesia (ASRA), anticoagulation guidelines.
- American College of Cardiology (ACC), periprocedural DOAC management. acc.org
Frequently asked questions
How long before surgery do I stop Eliquis?
Anesthesia (ASRA) guidance is about 72 hours (3 days), longer if your kidney function is reduced. Particularly if a spinal or epidural is planned. Some general surgery may use a shorter hold, so follow your team's exact timing.
Do I need bridging with Eliquis?
Usually not: DOACs like apixaban clear quickly, so most patients don't need heparin bridging.