Hi Ray, I am up taking my new perscription of Rthymol because, since my extraction, I go into afib weekly, instead of monthly.

The oral surgeon used Septocaine to numb the area of extraction.

Septocaine has Epinepherine. Folks with any heart problems are not supposed to have Epinepherine.

I would Recommend you make sure they do NOT use Epinepherine.

I had to stop Pradaxa for 3 full days before the extraction. I was supposed to start taking it that night. But, the bleeding had not stopped. It stopped the next day. So, Cardio dr. said to take it that night...5 days w/o Pradaxa.

I was in afib the morning after the extraction...but I did not know it until I checked my memory on my BPM.

I think you will be fine. I will have to have another one taken out soon.

TALK to YOUR DOCTOR PLEASE

Pradaxa Interruption for Colonoscopy, Dental Work, Surgery, etc.

When to stop the drug General comments

If you are on Pradaxa (Dabigatran) you may need interruption of therapy for dental work, a medical procedure such as colonoscopy, or minor or major surgical procedure. As to when exactly to take the last dose of Pradaxa before the procedure depends on (a) how big a procedure is planned and how much bleeding is expected to occur with it, and (b) whether a person is at high or low risk for a blood clot if he/she is off blood thinners for a few days.

It is important what your kidney function is

The way our body gets rid of Pradaxa is by excreting it through the kidney into the urine: about 80 % of the drug is excreted unchanged via the kidney. The remainder is excreted via the bile into the stool. In patients with impaired renal function (kidney disease) the drug stays longer in the body. Impaired renal function is assessed by a blood test called serum creatinine. An elevated level indicates impaired kidney function.

How quickly is Pradaxa out of the blood system if you stop it?

In most patients with normal kidney function, Pradaxas blood thinning effect is mostly gone within 1-2 days after the last dose has been taken. This is because the drug is relatively quickly excreted in the kidney. In medical-biochemical terms this is expressed as half-life (see table). In the person with normal renal function, half of the Pradaxa is gone within 13 hours (i.e. the half-life is 13 hours). Another 13 hours later another half of the remaining drug is gone (i.e. a total of 75 % of the drug is now gone), and so on. Typically, after 3 half-lives most of the drug (87.5 %) is gone. Most surgeries with a normal (standard risk) of bleeding can be safely done when the majority of drug is gone. For people with normal renal function that is ca. 24 hours after the last dose has been taken (see table).

However, because the majority of Pradaxa is excreted in the kidney, the drug will be excreted more slowly in people with impaired kidney function (renal disease). Thus, Pradaxa needs to be discontinued earlier before surgeries, such as 2 or more days before surgery (see table). If surgeries with a high risk of bleeding are planned, one will want all the drug to be out of the body. Depending on the renal function, the last dose of Pradaxa would have to be 2 or more days before the surgery.

petey

Petey,

How about Warfarin interruption for Dental Work and major/minor surgeries?

My Doc said to stop warfarin 5 days before surgery but to take
lovenox injections up to 12 hours before. And start warfarin 24 hours
after with lovenox injections untill the warfarin kicked back in.
But I canceled my surgery and will probably have it later on in the
year. It was a total shoulder replacement.

Oops sorry petey didn't mean to answer for you....

I can't justify a causal connection, but my second ever episode of Afib happened within 36-hours of having a root canal performed. Prior to that I had not had an episode since my first one four years earlier (Dr. said that was likely triggered by an overdose of cold meds and caffeine).

I am in no way trying to cause you concern or give you advice. Just reporting my own experience. I do wish you all the best as you deal with this issue.

in my experience every surgery and procedure is different as far as the rules for discontinuing blood thinners....some drs dont stop for certain things....some stop 3 days, some stop 5 and some want a full week, some want Lovenox and some dont.....I think everyone knows where I stand on epinephrine, dont have it, I even went through fairly big surgery and got them to agree to no epi....they love the epi cause it constricts vessels. Dental work is a big bleedy thing so Im sure almost all major dental work would have at least 3 days off of coumadin but surgery is another thing....I have seen things done on coumadin etc where I say .....really.....and I have seen other things done without coumadin where I also say ......really. :) So, very individual in preference

Agree. Every procedure anbd EVERY DOCTOR are not the same. petey

may be i should not go for exctraction , this is rather scary .leave the thing inside as it is .

My dentist has recommended extraction for a tooth with a root canal that in x-rays appears to be fractured.
That was 2 years ago. It's causing me no problems.
I would've gone ahead with the extraction if it were a back molar. However after the extraction an implant or a bridge would be required to preserve my smile which to me is all important. My feeling is that if I loose my smile" it's all over".
When/if it causes a problem I'll have it extracted.
I appreciate all of your comments re: the procedure as it related to AF.

Annette

my doctor recomended not to go off on warafin .so i am going with the xtraction and also then the implansts have to be done otherwise i would be scaring babies on my to work .

Ray,
Dentists vary in their preferences, but the trend now is not to stop warfarin, even for an extraction. You will do fine.

I am scheduled for my tooth extraction this Friday. I took Pradaxa last night, but will not take it again til after the extraction. If my bone is secure and all goes well, I'll have implant post also on Fri.

I have added drama. My bp has dropped way too low. Cardio dr. wants me off my bp pill. I told him I was fearful of going off of it entirely right now because I'm off Pradaxa and have added dental stress. I was also in ER last month with elevated bp.
I'll see him tomorrow.

I am doing all I know to do to stay calm and confident that all will be just fine and I'll be smiling pretty again in a few months (when I get my implant tooth) ( )