How is Apixaban toxic to my blood?
As Apixaban thins blood to reduce the chance of blood clots, the most common side effect is heavier bleeding(1). For example, spontaneous bleeding, nose bleeds, bruising and heavy menstruation(1). Due to apixaban preventing clot formation, bleeding continues which can lead to haemorrhage (bleeding)(11).
CAUTION: SURGERY
Undergoing surgery when taking apixaban is a risk due to potential hemorrhage.
Before surgery you may need to stop taking apixaban(6). This decision will depend on the risk of bleeding or clotting associated with the type of procedure(6). For minor surgeries it is not recommended to stop taking apixaban. However, for surgeries with high bleeding risk it is recommended to stop taking apixaban 48 hours before surgery(6). Surgeries or treatments that have a high bleeding risk when taking apixaban are(6):
- endoscopy surgery
- spinal/epidural anaesthesia
- lumbar diagnostic puncture
- thoracic surgery
- abdominal surgery
- liver biopsy
- kidney biopsy
- complex left-sided ablation
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How do I manage or prevent blood toxicity?
Management
- If you have a nose bleed DO NOT lie down, remain standing. Place ice on the top of the nose(1).
- Apply pressure to cuts for 10 minuets(1)
- When gums are bleeding use a soft toothbrush(1)
If you have serious bleeding, nose bleeds longer than 10 minuets, spontaneous bruises that keep growing or cuts that wont stop bleeding call 999 immediately (1)
Prevention
- Carry your anticoagulant card, and show it to dentists/doctors before surgery(1).
- Do not take apixaban if you have current bleeding from injury, or have have previous or current spinal injury(1).
- avoid sports that can injury the head such as rugby, horse riding and hockey(1)
- use hair remove cream instead of waxing or shaving to help prevent injury(1).
- Avoid taking ibuprofen