Blood thinning medicines (Antiplatelet agents, Anticoagulants) and minor surgery…
Blood thinning medicines (Antiplatelet agents and anticoagulants) are a common issue for patients having minor surgery, including removal of cysts, lipomas, moles, skin lesions and other small lumps. Patients take anticoagulants for many different reasons and in some cases it may not be safe to stop them. Find below some answers to common questions. This article is intended to help patients understand the issues before a minor surgical procedure.
Which blood thinning medications will this article cover?
The principles discussed in this article are true for all blood thinning medications, but there are specific issues that will be discussed in specific sections. Apart from Aspirin the article will cover Clopidogrel, Dabigatran, Apixaban, Rivaroxaban, Warfarin and others. Even if your personal blood thinning medication is not mentioned, it is worth reading on. We also cover Dual Therapy, which means you are on 2 blood thinning medications, and we finally give you some advice on self care while stopping blood thinning medications.
Click below to jump to those sections:
- Aspirin and Clopidogrel (Antiplatelet medicines, often after heart attacks or strokes)
- Dual Therapy (2 blood thinning medicines at the same time, often after heart valves and stents)
- Apixaban, Rivaroxaban and Dabigatran (Anticoagulants, often for irregular heartbeats, blood clots and strokes)
- Warfarin (older medicine where no other medicines are licensed or due to patient choice. Often well tolerated, mixes with many other medicines, and can be easier to plan around when patients have surgery)
- General Considerations: General advice about pros and cons of stopping blood thinning medicines before minor surgery
- Top Selfcare Tips: Read this section if you are on any blood thinning medicine.
Aspirin (and Clopidogrel)
What does Aspirin (Clopidogrel) do?
Aspirin and Clopidogrel are antiplatelet agents. These blood thinning medications reduce clotting by irreversibly inhibiting platelet aggregation in your blood. Platelet half time in your blood is about 5 days. Thus, after 10 days, roughly 25% of your platelets may still be affected. You can see how long it takes for the effects of Aspirin to reduce.
Benefits of Aspirin:
Secondary Prevention: By reducing the ability of your blood to clot, Aspirin can improve circulation in areas that are poorly circulated, for example after heart surgery, a stroke or a heart attack. Thus, you take it because a health event has already occurred.
Primary Prevention: However, there are also people who take Aspirin for primary prevention, meaning no previous problem, but a preventative choice. This may be because of their own risk profile or on medical advice.
What else can I do to avoid clotting:
Thick blood clots quicker than thin blood, so being well hydrated is a good way of avoiding more blood clotting than necessary. I would recommend anyone choosing to stop Aspirin before minor surgery that they always ensure they are well hydrated while Aspirin (or Clopidogrel) is stopped.
Is the removal of a cyst, lipoma, mole or lump minor surgery?
Yes. Procedures such as cyst removal, lipoma removal, mole removal and small lump removal are usually classed as minor surgery. However, the bleeding risk can vary depending on the size of the lesion, where it is on the body, how deep it is, whether it is inflamed or infected, and whether a larger wound or layered closure is needed. For example, a small mole shave is very different from removing a larger lipoma or an inflamed cyst.
Should I stop Aspirin (Clopidogrel) before surgery? And when should I re-start?
In major surgery Aspirin (Clopidogrel) is often stopped before surgery and sometimes replaced with Heparin. In minor surgery it depends, as there is a balance to be struck between the bleeding risk and the risk to your safety.
It is probably not good to stop Aspirin if you are taking it for secondary prevention, i.e. due to a previous problem with your heart or brain. If you take it for primary prevention, you may wish to discuss whether stopping it before minor surgery is sensible.
If you choose to stop Aspirin, it does not make sense to stop the day before as it will not work. You have to stop at least 10-14 days prior to the procedure and also not re-start while bleeding risk is increased, for example during the first few days after the procedure, depending on the wound and your clinician’s advice.
How about Dual Therapy (taking 2 blood thinners at the same time)
If you are on 2 blood thinners at the same time, minor surgery needs careful consideration. You may be on dual therapy, for example Aspirin and Clopidogrel, after a stent, heart valve procedure, stroke or another specialist treatment plan. In many cases this is temporary, but it can be very important not to interrupt it without specialist advice.
For elective procedures such as cyst removal, lipoma removal, mole removal or lump removal, it is often safer to wait until your consultant or GP has confirmed whether you can safely reduce to one blood thinner or whether surgery should be delayed. Please tell us before booking if you are on dual therapy.
Apixaban, Rivaroxaban or Dabigatran
Most of these blood thinners are important to avoid repeated blood clots and should not be stopped unless a medical specialist advises you to do so. However, their half life is quite short and, for some patients, a short period of stopping can be agreed with your doctor or specialist.
If your specialist agrees, your clinician may advise stopping them shortly before your minor surgery and re-starting once the bleeding risk is lower. The exact timing depends on the medicine, your kidney function, the reason you take the medicine, and the type of minor surgery planned.
If you stop them, you may have a lower chance of bleeding, but a higher chance of clotting. Please read below for top tips when stopping a blood thinning medication before surgery or any other procedure.
Warfarin
General Considerations considering minor surgery and blood thinning medicines
How high is my risk of clotting if I choose to stop Aspirin?
It is very important to be statistically savvy. Aspirin reduces the chance of blood clotting, it does not mean it stops you clotting. You can still clot while on Aspirin, but there is generally a risk reduction. For example, if 3 out of 100 patients would have a blood clot without Aspirin, fewer patients may have a blood clot once they take Aspirin.
In other words: most patients stopping Aspirin will not get a blood clot, but they may run a slightly higher risk. Equally, even if you are on Aspirin you still could get a blood clot.
If I have a procedure on Aspirin or another blood thinner, will I definitely bleed?
No. Most patients are absolutely fine, but occasionally patients can have more bruising, oozing, a haematoma, a longer dressing period or a need for extra wound care. Statistically, your risk is higher, but that does not mean you will have problems.
What should I do next?
For me as a doctor, it is very important for you as a patient to be well informed. That is why I have written the above article. Based on this information we can then make a shared decision balancing risks versus benefit of stopping. In the end, your decision is final. All I am asking you is that you consider the issues around blood thinning medications and minor surgery. If you choose to stop Aspirin or any other blood thinners, ensure your hydration levels are adequate throughout that time. If you choose to continue on blood thinning medicines, I want you not to worry about it as we will do everything in our power to make your experience as good as anyone else’s.
Top self care tips for patients choosing to stop blood thinning medications before minor surgery.
- Do not stop if your underlying diagnosis is serious, for example a recent stroke, heart attack, stent, blood clot or heart valve issue. Speak to your specialist before you make any decisions.
- Speak to your doctor before stopping and ask them what they would do.
- If you decide to stop, make sure you are staying well hydrated and do not get dehydrated.
- Aspirin has a very long effect on platelets. There is usually no point stopping only a day or 2 before. If Aspirin is being stopped for a procedure, this generally needs to be planned well in advance.
- Clopidogrel, Rivaroxaban, Apixaban and Dabigatran have shorter half lives than Aspirin, but they should still only be stopped if your clinician or specialist agrees.
- If you re-start too early after the procedure you could still bleed, especially if the wound is large, the site is under tension or there has been oozing after surgery.
- Warfarin has a long half life and is also difficult to titrate up again. If you are normally on an INR level of 2-3, discuss your planned minor surgery with the clinician managing your Warfarin. Please do not alter Warfarin yourself without medical advice.
- Martin Kittel
- Most recent update: 23/06/2026
- 1:45 pm
- Page first published: 23/06/2026