Resolved question:
Dear Doctor
My name is Noura Khalid, 41 years old from UAE. I was diagnosed in 9/2014 with pulmonary Embolism of background superficial vein thrombosis.. Currently I am on xeralto 20 mg
Past medical and surgical history: sickle cell anemia (on hydroxyurea 1000mg/1500 mg on alternative days). Post splenectomy and post cholecystectomy at age of 7.
I have two questions : 1- I would like to know if I want to do facial Botox should I stop xeralto?
2- should I continue xeralto for long term (life long)?
Thank you
Submitted:
4 Days
Category:
Pulmonologist
Dear Ms Noura Khalid,
Thank you for your query at DoctorSpring.com
1- I would like to know if I want to do facial Botox should I stop xeralto? - yes. There have been reports of vein lacerations, bleeding because patients were on aspirin. So I would suggest that it has to be stopped.
2- should I continue xeralto for long term (life long)?
What was the episode triggering a embolism? Travel , surgery etc? With background of sickle cell anemia, I do suggest long term ( life long) anti consultation.
My answer to the second question may change, if the embolism was precipitated by some Major events. In that case, 3 months of drug will be enough.
Hope that helped. I would be happy to help you in case you have further questions.
Regards,
Dr. Jacob George P
MD IDCCM FCCP
Thank you for your reply. I did even thrombophilia screening which was negative. The one reason is I travelled to India from Dubai, made a lot of trips with internal flight and a 3 hours road trip by car. After that I developed superficial Thrombophilibitis which was cloted just 2 cm proximal to popliteal vein. With background of sickle cell anemia that was the reason of my embolism. My question is if I am going to stop 24 hours prior facial Botox which will be next month , am I eligable to do stop xeralto even if it is less than 6 months from event ( pulmonary embolism even was in 19.9.2014) ? And if I am eligable, should I stop xeralto 24 hours prior and 24hours after Botox . Thank you so much for all of your efforts
Dear Ms Noura Khalid,
Regards from our side once again.
I presume that the embolism occurred because of plane travel and not because of sickle cell anemia. However, as you are prone for embolism, I prefer you continue it long term.
-? And if I am eligable?
Yes, of you have completed 3 months you are eligible to stop xeralto.
-? should I stop xeralto 24 hours prior - yes you should, and that's what's advised. and 24hours after Botox - if the procedure went uneventful, with no bleeding, you can safely restart xarelto after 5 - 6 hrs of procedure. That will not pose an added risk for bleeding.
Regards