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dermdoc19
dermdoc19, Dermatologist
Category: Dermatology
Satisfied Customers: 4124
Experience:  30 years practice in general and cosmetic dermatology
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I have to go o a day clinic minor surgery unit to have a small

Resolved Question:

I have to go o a day clinic minor surgery unit to have a small growth removed from the tip of my ear . The consultant dermatologist has asked a plastic surgeon to remove it and told me that I'd probably have to stop taking warfarin prior to the operation. I take 4mg sid adn have an INR of 2.3 and am monitored about every three months now. I have AF and take also 100mg flecainide bid.

My concern is that an abrupt stop to warfarin might triggier a hypercoagulation incident and possible stroke whereas tailing off the dose of warfarin may have the same effect. With a half life of about 37 hrs what would be the time needed to reduce the anticoaulant effect

What is your advice?
Also had I been on an irreversible anticoagulant what would the plastic surgeon do then?

Look forward to hearing from you
Submitted: 3 years ago.
Category: Dermatology
Expert:  dermdoc19 replied 3 years ago.

dermdoc19 :

These answers are for informational purposes and do not replace a physician head-to-head visit. A patient-physician relationship is not established.

dermdoc19 :

Hello

dermdoc19 :

Thank you for your interesting question and all the details regarding your anti-coagulant treatment. My advice is to consult with your cardiologist. In the United States we are more and more reluctant to take patients off their anti-coagulant at all for skin surgery. It is felt that the reason the patient is on the anti-coagulant supersedes any benefit of limiting bleeding. With that said, it is not for me to interfere your treatment plan. For that reason, I would put the decision in the cardiologists hands, inform him or her of the planned surgery, and have him/her make the adjustment.

dermdoc19 :

I hope that helps, and please feel free to get back to me.

Customer:

Thank you - will do

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