How long should anticoagulant medications be discontinued before surgery?

Generally, surgery can be considered 2 to 7 weeks after discontinuation of anticoagulant medications. This is because anticoagulants inhibit blood clotting and increase the risk of bleeding during surgery, so they need to be stopped in advance to ensure surgical safety. During the period of discontinuation, patients should follow medical advice for necessary examinations and monitoring to ensure surgical safety. The analysis is as follows:

Warfarin-type drugs have a long half-life and their effects last relatively longer, generally 2 to 5 days. They should be discontinued at least 5 days before surgery to ensure complete clearance from the body. High-risk patients may experience an increased risk of thrombosis after discontinuation; in such cases, low-dose low molecular weight heparin may be administered subcutaneously to prevent complications such as deep vein thrombosis and myocardial infarction.

Rivaroxaban-type drugs are highly selective direct factor Xa inhibitors with a relatively short half-life. Short-term discontinuation cannot completely eliminate their impact on bleeding during surgery. Rivaroxaban should be discontinued 2-3 days before surgery to reduce the risk of intraoperative bleeding. Especially for patients undergoing procedures such as epidural anesthesia or lumbar puncture, discontinuation time should be more adequate.

The duration of drug discontinuation should be comprehensively evaluated by the physician based on the patient's specific condition, along with monitoring of relevant blood parameters. Before deciding on discontinuation timing, patients should undergo a series of tests, including coagulation function tests, to ensure surgical safety.