When should a patient with a high risk of bleeding discontinue Eliquis (apixaban) prior to undergoing a hysterectomy?

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When to Discontinue Eliquis Prior to Hysterectomy

For patients undergoing hysterectomy, discontinue Eliquis (apixaban) 48 hours (2 days) before surgery, as hysterectomy is classified as a low-to-moderate bleeding risk procedure requiring some residual anticoagulant effect to be acceptable. 1

Bleeding Risk Classification of Hysterectomy

Abdominal hysterectomy is specifically categorized as a low-to-moderate-bleed-risk surgery with a 30-day risk of major bleeding between 0-2%. 1 This classification is critical because it determines the duration of apixaban interruption needed before the procedure.

Recommended Discontinuation Protocol

Stop apixaban 48 hours (2 days) before the scheduled hysterectomy. 1, 2 This timing allows for approximately 2-3 drug half-lives of interruption, which is appropriate for procedures where some residual anticoagulant effect is acceptable. 1

The FDA label for apixaban confirms this approach, stating that apixaban should be discontinued at least 48 hours prior to elective surgery or invasive procedures with a moderate or high risk of unacceptable or clinically significant bleeding. 2

Supporting Evidence for 48-Hour Hold

Real-world data supports the safety of this approach. A prospective cohort study of 111 patients found that apixaban discontinuation for at least 48 hours before a procedure resulted in clinically insignificant anticoagulation levels, with 94% of patients achieving apixaban concentrations ≤30 ng/mL. 3 The median time between last dose and surgery was 76 hours in patients who achieved safe levels. 3

Key Considerations for High Bleeding Risk Patients

If the patient has additional bleeding risk factors or if the hysterectomy involves particularly high-risk features (such as extensive cancer surgery or anticipated difficult hemostasis), consider extending the hold to 72 hours (3 days) before surgery. 1 The French Working Group on Perioperative Hemostasis recommends this extended interruption for high-bleeding-risk procedures. 1

Bridging Anticoagulation: Not Recommended

Do not use bridging anticoagulation with heparin or low molecular weight heparin when interrupting apixaban for hysterectomy. 1 The rapid offset and onset of action of direct oral anticoagulants like apixaban eliminates the need for perioperative bridging therapy. 1

Resumption After Surgery

Resume apixaban at least 24 hours after hysterectomy, provided there is adequate surgical hemostasis and no ongoing bleeding concerns. 1, 2 For patients with particularly high bleeding risk during the procedure or concerns about hemostasis, consider delaying resumption to 48-72 hours postoperatively. 1

The FDA label specifies that apixaban should be restarted after surgical procedures as soon as adequate hemostasis has been established. 2

Common Pitfalls to Avoid

  • Do not hold apixaban for only 24 hours before hysterectomy, as this is insufficient for a procedure with moderate bleeding risk. The 24-hour hold is reserved only for minimal-bleed-risk procedures like cataract surgery or minor dental work. 1

  • Do not routinely measure apixaban levels before surgery, as this is not necessary for standard perioperative management. 1

  • Do not restart apixaban too early postoperatively. Bleeding complications after hysterectomy, while uncommon (median blood loss 215-660 mL), can occur, and premature anticoagulation resumption increases this risk. 4

  • Avoid the temptation to bridge with LMWH, as this significantly increases bleeding risk without reducing thrombotic events. 1

Algorithm Summary

  1. Classify the procedure: Hysterectomy = low-to-moderate bleeding risk 1
  2. Standard hold: Stop apixaban 48 hours before surgery 1, 2
  3. Extended hold (if high-risk features): Stop 72 hours before surgery 1
  4. No bridging anticoagulation 1
  5. Resume: At least 24 hours postoperatively with adequate hemostasis 1, 2

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Complications of hysterectomy.

Obstetrics and gynecology, 2013

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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