What ! is the brief of the anticoagulent clinic is respect of NOAC (Apixaban) ????

Hello All,

I have been been advised to take Apixaban by my local Cardiologist and the EP at St Bart's in London who looks after my ICD and AF control. The Cardio has sent me a letter advising me to start the Apixaban, see my GP, discuss taking the NOAC and also arranged for me to go to the anti coagulent clinic .

I was advised by my Heart Specalist Nurse that the NOAC could ony be prescribed at the Clinic.

However when I saw my GP he said no and prescribed the Apixaban there and then stating that it was too long to wait for an appointment to the clinic. Since then I have had an email from my H.S. Nurse informing me that it will take another 6 weeks before the clinic will fit me in. My question is can anyone enlighten me as to what procedures I need to follow before I start the tablets . What precicely is their role in this .

Can I just start taking the tablets without waiting for the clinic appoinment.

Can anyone throw any light on this question

I have read many reports on here about Apixaban and a great percentage of contributers are in its favour.

I have various Heart problems which are assisted by drug therapy .Drugs for other things and rattle all day. Not happy about adding a few more.

I have never been on Warfarin and I am high risk about 6 o7 on the Chad list. Thank you B

10 Replies

  • HI blackbear and welcome. To be honest I don't think the anticoag clinic has much to do if you are on NOACs as there is no regular testing unlike warfarin. So long as you take the pills as directed you are covered against the increased stroke risk which your Chads score most definitely gives you. So long as there are no contra indications with any of your other meds then I would go for it. Since NOACs are approved by NICE I can see no reason why your HS Nurse told you what she did. Provided that your local CCG are prepared to prescribe it then all is good. I think it is a good idea to have some kind of annual check up for various things like liver and kidney function but other than that plain sailing.

    And this from somebody on warfarin!


  • I've been taking Apixaban for just over a year without any difficulties. In order for a patient to be placed on the correct dose (either 2 x 5mg or 2 x 2.5mg daily) , a kidney function test should be done, which might explain why your nurse wanted to refer you. The lower dose is normally prescribed for people with impaired kidney function - something which the test detects and tests should be repeated annually.

    As you have been advised to start the drug, perhaps asking your GP about the test might speed things up - it's only a simple blood test - and a six week wait seems excessive.

  • You might find this link helpful in explaining the NOAC's:


  • Hello All,

    Thank you for your prompt replies. I had a full blood test in the middle of Jan before this Noac was advised after a meeting with the Cardio and the HS nurse/team and later prescribed by my GP 5mg twice a day. I just wanted to know what the Clinic's part was in all this. Anyway thank you all very much for your time and advice . This is a great site. Wish me luck I will start it tomorrow. Every day is a GREAT DAY to have another PILL !!!. Regards B.

  • I have been on Apixaban for nearly three months and have been pleased with it- you need to take it at the same times each day- I've got a watch alarm for the twice a day timings

  • One thing I have learned from this forum is that there seem to be few hard and fast rules about who manages a patient's AF and any drugs prescribed. In my case - congenital heart patient, 2.5 years post valve replacement - Consultant has recommended medication but written to GP asking her to prescribe. This also seems to have happened in your case so I'm not sure why you are also being referred to an anticoagulation clinic?

  • I've been on Apixaban several months - no problems at all. The anti-coagulation clinic, probably more accurately described as the warfarin clinic, has no role in the management of your AF. Your doctor has prescribed 5mg (the usual dosage), so set your alarms and enjoy this simplest and most reliable form of stroke protection.

  • I am trying to get my GP to change my warfarin to Apixaban but he has refused, I believe purely on a cost basis. I need to try again however, as I have now discovered that NICE recommend Apixaban for anyone with AF as well as Diabetes, which is me. I believe the reasoning behind this is that people with Diabetes need to follow a healthy diet including greens and veg etc. Warfarin is restrictive to many of these foods due to the amount of vitamin K in them. Apixaban does not impact on diet, hence the NICE recommendation.

    My firm belief is that my Diabetes is linked to my Sotalol intake for AF. My sugar levels went up in direct proportion to my Sotalol dosage and have reduced in line with my reduction in Sotalol. I don't want my sugar levels to go back up and was wondering if anyone has any knowledge or experience of Apixaban raising sugar levels.

  • B, all I can say is thank goodness you are at last on an anti coagulant

  • I was prescribled Apixaban by cardiologist when I was taken into hospital with bad episode of AF, also a Specialist nurse came to see me to explain the ins and outs, I was really quite afraid of `bleeds` for about 3 months but now I dont think about it as much just when we have an inicident when out driving in the car but I pray each morning that God will take care of me and He does,

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