Another question please.: Thank you to... - AF Association

AF Association
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Another question please.

cmjoyce
cmjoyce

Thank you to everyone who replied to my posts.

I can not get in to see my GP until Wednesday so I have time for another question.

Those of you on NAOC's, does the fact of no antidote scare you or have you been given any reassurance about what could be done if a major bleed did occur?

Anyone taking Apixaban on the 2.5mg twice daily dose as I think this would be the dose I would be given as I am elderly and do not weigh much. I also have some kidney damage.

Joyce

14 Replies
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Hello Joyce. My Apixaban dose is 5mg x 2 and I did not know about there being no antidote until I joined this forum three months after it had been prescribed! My lifestyle (I'm 70) does not involve any high risk activities, except driving which is kept to an absolute minimum by choice and I don't have any history of bleeding, so I'm happy enough. The drug companies hope to have the antidote on the market shortly, so that will take care of the problem, I hope.

In the event of a serious bleed - which would be limited by the half life of the drug (around 12 hours) - I believe plasma can be used to treat it.

BobD
BobDVolunteer

Although I am on warfarin by choice and used to be against these NOACs for that reason. discussion with experts change my mind as I was assured that cell packing transfusions and the very short half life of the drug would make recover quite possible. Since then I have advised people who are unable to maintain good INR that NOACs are a viable alternative to warfarfn.

Peddling
Peddling in reply to BobD

Hello there, I too am on 5mg x 2, and a number of other pills, some af related, plus thyroxin for under active thyroid. I agree the NOACs are a bit of a leap into the dark, but I was unable to reach the necessary range of protection on warfarin. Frankly, for me the fear of a stroke far outweighs the fear of lack of antidote. I felt very vulnerable on warfarin, much less so on Apixaban. The important thing is that you feel comfortable and have confidence in whichever anticoagulant you are prescribed. The cardiologist will explain to you how a bleed would be managed. He/she will also explain how the noac's work in your system. The answer that most people want answered is, how do I know I'm protected? Good luck.

souljacs4
souljacs4 in reply to BobD

Can I ask Bob what would be your choice of the new AOG if you had to change from warfarin

NJ47
NJ47 in reply to BobD

I feel even happier on it now, Bob. Thanks :-)

BobD
BobDVolunteer

Sorry I don't have an opinion on separate drugs. This needs to be decided by a doctor according to your own medical history .

I have been on Riaroxaban for just over a year with out any problems. It did scare me a bit knowing there is nothing available at the moment to reverse their effects should I have an accident. However, as Finvola has said the half life of the drug is relatively short, I also looked at my lifestyle - I don't carry out high risk activities and for me the benefits outweighed the risks, but in the end I guess it is dependent on medical advice and personal choice.

yes, it does scare you at first, I am on Pradaxa one of the new anticoags, been on it for 5 months. I thought about it daily for a few months, driving the car, crossing the road. I had a small bleed when my husband accidentally nicked my ear when trimming my hair, stopped after an hour or so. But its the internal bleeds that are most worrying or accidents etc. All I was told was that hospitals have things in place for when emergencies occur, I think they give you blood transfusions and wait (hopefully) for the drug to get out of your system. It has a short half life 12 - 18 hours I believe. So be assured you will get used to living with this and all the time research is looking for antidotes so I am prepared to learn to cope and trust God and live as careful as I can.

Pat

Hidden
Hidden

i switched from warfarin to pradaxa last april and no untoward events. Antidotes are being sought and as someone else says there are measures that can be used until medication has left system. I carry a card in my purse, i have a locket with info on my meds and use rubber band type braclets stating on pradaxa and have a pacemaker. Figured ive covered most bases.

When first diagnosed with AF my doctor said that she believed that one of the NOACs was the way to go but wanted the Consultant EP that she was referring me to, to decide which one and he recommended Apixaban. Both of them highlighted the pros and the cons of Warfarin and NOACs but even though I do some DIY I decided to go down the Apixaban route. Part of the fact was due to the testing, food and other aspects associated with Warfarin. I am a professional engineer / project manager and used my work skills to do a risk analysis from my perspective. I decided that although the half life is around 16 hours but if you had a serious bleed and they pumped two or three units into you the half life would come down dramatically because of adding the normal blood. In addition if you had the bleed in the second half of the period between taking the two tablets then the effect was already reduced. There were other factors as well. My reasoning may not apply to others and I am not medically qualified in any way!!

Because of a failed cardioversion and the need to have a catheter ablation I was started on Warfarin on 5th January. However I am one of the unlucky ones and having problems getting the INR anywhere near stable. Have mainly got over the intolerances which lasted about 6 weeks (I generally have intolerances to medicines to start with) However I only have 3mg and they vary it up and down by 0.5mg but the INR swings from 1.8 to 4.4 despite me making a very conscious effort to keep diet constant. After ablation I definitely want to go back on the Apixaban.

Hi Joyce.

I take Rivaroxaban and know there is no antidote as yes , but as my cardiologist said " don't worr we won't let you die " so I just take it. It suits me and I'm very happy with it.

Good luck.

Hi Joyce,

I'm 48 and on Rivaroxaban, one of the NOAC's. No, I'm not worried about there not being an antidote. I weighed up the pros and cons when I first went on it. My lifestyle is simply too busy for warfarin and I'm finding my meds a breeze. Hope this helps

NJ

There is an antidote being trialled at the moment with great success as I read about it on this forum!

Can't find original post but search forum for antidote NOACs

I'm on Warfarin by choice. I tried one of the NOACs but had a bad reaction to it, so chose to go back to Warfarin, and I've bought my own testing meter which is there to hand for peace of mind, but generally I only test myself every 6 weeks or so. A few years back I did have a fall at home and somehow tore open my lower leg (the scar is 5" x 2"). It bled prefusely. It was a Saturday night and the paramedic didn't arrive for 55 minutes, during which time a clean towel was pressed against the wound. At hospital I had to wait another 40 minutes as they had some more urgent cases. I expected to be given a shot of Vitamin K to stop the bleeding, but wasn't given anything (apart from a glass of water to drink and some food). The reason was that I was, at 2.7, within the INR range that I needed to be. That was deemed to be more important than losing blood. The wound was cleaned, and then closed with closure strips. The wound was dressed several times a day, and I was discharged after 2 days to the care of the nurses attached to my GPs practice. They continued to dress the wound regularly for about three months, until it scabbed over. I now have fibrosis around the wound and secondary lymphoedema on the that leg but wear a long compression sock and it doesn't affect me in any other way.

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