Apixaban dose

[Elaine1951]

I'd welcome the views and experience of others regarding dose and prescription if Apuxabsn long term. I've had only two AF episodes, both scary enough for me to take anything in told. However I just would like to have some future hope of not always bring on 10 mg Apixabsn for life which is what cardio suggests. I'm 65 female. Weighing 53 kg. Thiughts and experiences welcomed.

[BobD Volunteer]

I agree with your cardio I'm afraid. Stroke is not a very nice thing to happen so anything is better. You can never be sure that you do not have events you are not aware of so best to be cautious.

[Elaine1951 in reply to BobD]

I suspect you're right. Thank you for responding.

[PeterWh]

Not sure what weight split is but look on manufacturer's leaflet because I think with Apixaban up to a certain weight it is 2 x 5mg pad (unless that is what you mean by 10mg.

I agree with bob and cardiologist. In fact even if I didn't have CHADSVAC of 2 I would definitely take Anticoagulation. I have seen devastating effects of a stroke on people in 40s upwards. One lived for about 17 years paralysed from neck down and could only speak a few words and grunt. However Brian was 100% there (in fact his sister reckoned it was 200% - ie sharper after stroke than before.

[Annekw]

Hi I've been on Apixaban now for10 months,5mgs twice daily,as far as I can see,no side effects so I wouldn't worry,you just have to remember to take it every 12 hrs to make sure you're fully protected! I set my phone alarm for my evening dose as when I'm out I tend to forget to take it!

[Elaine1951 in reply to Annekw]

Thanks, Can I ask if you're being treated in the Uk and if you are male or female and also body weight?

Thanks

[Annekw]

Hi yes I'm in UK but diagnosed in Tenerife,and treatment started there! (On holiday!)

I'm female just 70yrs old, previously no history of heart trouble,I do have Rheumatoid Disease!

I'm 5ft 8" and 11st!

I've had one Conversion in Tenerife which failed after 3days. Ian having another shortly.

[dmac4646]

on Apixiban 2X5mg no side effects I am aware of so in my case why take the risk

[paulh1]

I've been taking Apixaban for over a year now. The only downers with this meds are: you bleed like a bad leaky faucet when you get cut and the most important is there is no approved antidote for this. They are working on one called Annexa but it hasn't been approved by the FDA here in the US. The only anticoagulant with an approved antidote at this time is Pradaxa

[Elaine1951]

v helpful e

[Finvola]

I've been on Apixaban 2 x 5mg for just over 2 years and the only side effect is what is expected from an anticoagulant - it prolongs coagulation. I suffer from allergy-induced nosebleeds but even after a few A&E trips, my GP advises keeping to the higher dose for protection against something much worse than a nosebleed.

Try not to worry too much - at the beginning I did, but you get used to taking the drug.

[Finvola in reply to Finvola]

You might find this link of interest if you haven't already seen it:

networks.nhs.uk/nhs-network...

[Kodaska]

You do not necessarily need the amount of apixaban - or any other anticoagulant, or any drug, for that matter - you've been prescribed. In the case of apixaban, I strongly suggest you find out how much your dose reduces your chance of a stroke. In my situation, at age 66, post-ablation with zero breakthrough arrhythmias, my statistical chance of a stroke - with no medication - is 2.2%. It goes down 0.7% with each 5mg of apixaban. So with 5mg/day it's 1.5%, and with the 10mg/day (5mg/dose) I've been prescribed, it drops to 0.8%.

Do these percentages mean anything? Is a 1.4% drop in a statistical probability worth the bleeding? For me it's not much of an issue but for others it might be.

Also, as paulh noted, apixaban does not have an antidote. Pradaxa can give you truly awful heartburn (I stopped it for that reason) but at least its effects can be reversed.

Ask your doctor what your untreated probability is for a stroke. That's right, the statistical likelihood without any anticoagulant. If s/he can't or won't tell you, pursue the matter until you get a credible answer. Then make your own decision.

I cut my apixaban to 2.5mg 2x/day back in September and will not refill it when it's gone next week. I'll take my chances with a 2.2% probability of stroke.

[PeterWh in reply to Kodaska]

It is important for anybody considering cutting doses to assess and review other factors which may include, but not be limited to, type of AF, frequency of AF, other arithmyia, other heart problems (eg leaking valves), circulation issues, blood pressure, etc, etc. Then make final assessment.

[PeterWh in reply to PeterWh]

Also any other ailments or problems.

[KipperJohn]

I was diagnosed with PAF in 2010 but was not put on a proper anticoagulant until July last year when I finally got to see an EP about an ablation. He prescribed Apixaban 5mg x 2 daily immediately and, quite frankly, I felt relieved as I'd been worried about the stroke risk for some time but somehow couldn't get past my GP and aspirin (which I take for other heart issues anyway).

It is so important with specialist conditions like AF to get the best advice and I was lucky that my regular GP went on holiday and I saw another GP who was more than happy to refer me!!

[Annekw]

At the moment people the antidote is a red herring in UK for not prescribing the expensive NOAC drugs!

Apixaban as it is taken 12 hrly has a "short shelf life " meaning that you do not bleed excessively ! It is frightening at first but most Doctors who actually prescribe NOAC,s do prefer Apixaban!

[Hidden]

I am a 74 year old female diagnosed with PAF seven months ago. Rarely have episodes and they are usually fairly short and never with very fast heartbeats. I didn't get on with rivaroxyban and the bumf that came with the apixaban which I have instead, mentioned that you should have half the dose if you weigh under 60kg. As I weigh just over that, I negotiated with my doctor to take 3x 5mg over 2 days instead of 2 daily. Perhaps you could try that as you do weigh under 60kg (it might also have mentioned being over 80 too) but try talking to the medic. Good luck. Doses are usually calculated for the average male so us females have to argue our way to more suitable mediaction!