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I take warfarin to manage my APS. I injured my back quite severely 10/08, and have had the "joy" of dealing with this, as well as lupus, as well as Fibro, as well as APS. Life as a lupie .... :rolleyes:

After consulting with a pain specialist, we decided to try another epidural cortisone injection in my spine to decrease swelling and impingment of my nerves. A fairly safe procedure, unless you are on anti-coagulants.

Last time I had this done, I went off the warfarin, started Lovenox shots, stopped the shots just prior to surgery, then restarted both after.

My new heamotologist has put me on Arixtra this time instead of Lovenox. It was a HUGE inconvienance, costly, and time consuming "experiment".

:eek: When I researched this Arixtra drug, I found a "black box warning" (US gov. made them print the warning, not volunteered) regarding taking the drug with spinal anesthesia! :eek::eek::eek::eek:

:panic:Of course I called the doctor immediatly, and he reassured me that the drug would be out of my system for surgery Friday morning if I took my last dose today (Thursday).

Last night, I get another call from the doctor, and now he wants me to hold todays dose as well. Methinks I smell a medical mistake here, and now wonder if I should postpone the surgery until the Arixtra is out of my system. :smirk:

Any one else with any experience with this drug? Thoughts, comments? Help ...... ?????? :)
 

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Hey Tracy,

I don't have any experience with Arixtra I'm afraid, but I have aps too and was on lovenox for it until recently when I was switched to fragmin shots. I just wanted to say that both lovenox and fragmin have warnings against spinal anesthesia or spinal taps; I think that's just standard for injectible blood thinners (I say injectible as I'm not sure at all if coumadin has the same warning or not).

Now lovenox lasts for 12 hours with a half life of 4.5 hours which is why people usually have to self-inject twice a day on lovenox. From what I can tell arixtra stays in your body for 24 hours and has a very long half-life (17 hours). Thus depending on the hour of the day your spinal shot will take place (if it's early in the morning and you take arixtra on the afternoon of the previous day etc etc etc) I think it probably makes sense for you to be off the med for at least 24 hours or more so that you're sure it's not in your system anymore.

I don't think you should postpone the procedure because of this as if you're off the injections for 24 hours (and if you don't do Wednesdays shot either then it'll be closer to 48 hours actually!) you really shouldn't have any bleeding complications. However I do think that since you seem to have a few concerns about all this and some unanswered questions (quite understandably too, I think we all would) that it might be a good idea for you to call your doctor and discuss this all with him once more.

Hope everything goes well with the cortisone injection! :)

:flowery:

Zoi
 

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Hi Tracy,

I have not even heard of the drug but I always say follow your female intuition. If you do not feel comfortable then post pone the surgery. If you trust your doctor and know he is competent then go forth with the plan.

I am sure that he would not risk a mal practice situation knowing what lies ahead of him based on your meds and history.

Good luck and let us know how you make out, and of course if I can help in anyway.:wink2:
 

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They will (or should) run blood clotting tests on you the morning before your surgery too to make sure that there will be no bleeding complications. I would probably go ahead with the procedure but just make sure that you ask them all your questions before starting the procedure, and that your blood tests fine in terms of ability to clot.
 
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