Query about Apixaban

[Nelb]

I have been on Apixaban for four weeks and the doctor said to have an INR test today and it was 1.1 which surprised me as last week my baby grandson scratched my ear and it bled like water. Anyone have any idea what INR is ideal with Apixaban? I have AF but a week long episode monitor found only two occasions when my heart rate was abnormal.

[nigelfarruca]

I have been on Apixaban for 7 months. My readings are, Routine Anticoagulant (DK263)-inr is 1.8. Prothrombin time 21.1s. Hope this helps it's all new to me and I was never on Warfarin. But I do know the standard limits for Prothrombin time is 11.60 - 13.90s.

Regards nigel (not in AF today).

[BobD Volunteer]

This is stupid as INR testing is not relevant for NOACs such apixaban. INR testing only helps to define the anticoagulating benefits of warfarin.

[gemsmum in reply to BobD]

I have been on apixaban for 4 months and have not been told I need any INR testing, I agree with Bob that it is not relevant. I had a blood test to see if my kidneys and liver were OK before starting and then 1 month after, I will check again if I need another blood tests in about 6 months, hope this helps.

[toohardbasket in reply to gemsmum]

Yes, likewise for me....initial kidney check but was told there was no need for the monthly test the way they do for Warfarin. That was why I decided to go for it - the less bother, the better!

[Finvola]

The NOAC's use a different method of anti-coagulation from Warfarin and INR testing is unnecessary. I take Apixaban and have annual liver function testing but the nurse who took the sample last time was quite worried about the fact that weekly INR testing is not done! I think it is a matter of some medical people catching up with advances in methods and medicines.

[Nelb]

Thanks everyone for your helpful replies.

[AnticoagulateNow]

Your doctor Nell should be in front of a disciplinary board as soon as possible. Basic re-education is needed with some urgency before he or she is ever allowed to face a patient again! Unless that is, your doctor was simply checking that the warfarin was out of your system - though heaven knows why, as after 4 weeks it most certainly is.

And Nigel, are you testing yourself for INR as though you were on warfarin? Why? You are on Apixaban which works in an entirely different way?

[Nelb in reply to AnticoagulateNow]

Well you could say I am the dunce here.

The doctor knew what to do but didn't tell me. She said I needed to have blood tested (INR) two days after I finished Warfarin. The nurse who did the test then phoned the doctor to check if I could start Apixaban and she said, relayed to me by the nurse, that I should have blood tested in four weeks.

No explanation and no form or instructions or appointment so I made an appointment with the nurse and she did the INR 4 weeks later. She knew nothing about NOACs because she suggested diet may have affected the result. The nurse phoned me a couple of days later after speaking again to the doctor to make an appointment to have the correct blood tests done.

The real problem here is the lack of communication resulting from having less than 10 minutes with the doctor at an appointment after a long wait and her/his mind being on having a waiting room full of people and catching up if possible.

I am in my 70s with a lot going on medically and in the family but I should have looked it up. Relying on GPs to explain everything is now a thing of the past where I am.

[AnticoagulateNow in reply to Nelb]

All understood Nell...your INR has to be at 2 or below before starting Apixaban so a check then is necessary but not after 4 weeks. Anyway, it's certainly not your fault. I've found the changeover from warfarin to apixaban a breathtaking liberation. I hope you do too.

[Nelb]

Thanks AnticoagulateNow.

Lovely to be able to enjoy the fruits of my labour in the vegetable garden without counting the cost.