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Dr. K.
Dr. K., MD
Category: Medical
Satisfied Customers: 4527
Experience:  Board certified.
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My mother (who had a stroke while on warfarin) has been

Customer Question

My mother (who had a stroke while on warfarin) has been receiving Xarelto 20mg daily since 11/2016. She developed black tarry stools 4 days ago, with quiac positive lab. Dr. ordered a CBC (waiting results) and to hold med for 7 days. My question: With no current antidote for Xarelto , what options does a person have if the bleeding continues?
Submitted: 1 month ago.
Category: Medical
Expert:  Dr. K. replied 1 month ago.
Hello and welcome to Just Answer. I looking forward to assisting you with your question and providing excellent service. The xarelto is not affecting the bleeding profile at this point. Its not helpful just to hold the medication and do nothing unless there are obvious hemorrhoids causing the bleeding. If your mother is healthy enough to have a colonoscopy and upper gi, the source of the bleeding should be investigated
Customer: replied 1 month ago.
If you don't me asking, what is your specialty? My research shows "black stools indicates upper GI bleed" . Hemorrhoids would cause "bright red blood". Since she is 96 yrs old, I would not consider her an ideal candidate for a EGD or Colonoscopy at this stage. Why is "xarelto not affecting the bleeding profile at this point"--if Xarelto coagulation can not be monitored (like warfain)? " Its not helpful just to hold the medication and do nothing"-- what should a individual do? continue taking Xarelto or start another anticoagulant once bleeding has stopped?
Expert:  Dr. K. replied 1 month ago.
I work in elder care/geriatrics doing mainly hospice and end of life care. You are correct, black stool is likely upper gi bleed. I only mentioned hemorrhoid in that holding the xarelto is not helping anything unless its only and obvious hemorrhoid. You are correct in that your mom is not healthy enough due to age alone to tolerate any procedure. Xarelto or any other anticoagulant is contraindicated in the face of Gi bleeding. She would need to stop completely. One option may be just 81 mg aspirin.