Further update on my AF

I spoke to the head Dr at my surgery today and he said he did not say for me not to take rivaroxaban, he said as my stroke risk was only 2.2% he would rather me be on aspirin because of my heart attack in 2007. (He did tell me to stop the rivaroxaban)

However, although I am not against taking anticoagulants my main concerns are

1- I have an evar stent in my aorta due to a AAA and am more concerned about that developing an endoleak causing my aneurysm to rupture because if that happens I have no chance of survival at all.

2- rivaroxaban has no antidote so if I am unlucky enough to get a serious bleed that's me done for as well.

My Dr has told me it is up to me to take the rivaroxaban but stated that I MUST take 75mg aspirin and 1.5mg of bisoporal daily and there is an increased risk of bleeding by taking aspirin and rivaroxaban together.

Does anybody know of a NOAC that has an antidote please.

It seems to me that I am toast no matter which route I take.

Thank you all for listening and your patience with me.

Regards

Roger

10 Replies

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  • Hi Roger. It sounds as though your doctor has atleast clarified things for you and now you can start to deal with the facts. There are others on this forum that can say a lot more than i about anticogulants but as i understand it, warfarin is the only one that has an antidote that takes immediate effect but it is expensive and i dont think it is carried by ambulance crews. To be honest, your doctor does seem to be in control of the situation and at least he is giving you the choice as whether or not to take riveroxaban. Sometimes though we would rather not be given the choice but have someone tell us what to do!

    I am glad you have updated us. I must admit that i was a bit worried about you.

    Take care x

  • Thank you dedeottie, that means a lot to me. I only wish my wife shared your concerns. X

  • Roger. See my comments in response to other posts this evening.

  • Here in the US I believe there is but one and another is on the way later this summer. Andexanet alfa is a FXa Inhibitor Antidote for Eliquis, (apixaban) and Xarelto, (rivaroxaban), which should be out later this year.

    Dabigatran (Pradaxa), has an antidote Reversal Agent that is called PRAXBIND.

    It was approved on October 16, 2015 by the FDA. You can look at the prescribing information here us.boehringer-ingelheim.com...

    For some reason my cardio wants me on on Eliquis and a 81mg aspirin also. I have an appointment on February 1st to see an Cardiac Electrophysiologists and I am making a list of questions with one being do I need to stop the aspirin. Best wishes to you and I would think by the end of 2016 there will be an antidote for all the NOAC's.

  • From what little I know Roger and from what your doctor has said, the aspirin is more important for your survival than the anticoagulant. Yes aspirin is very important when you have a stent. If your doctor thinks the risk of taking rivaroxaban as well is greater than your stroke risk then you have your answer.

    I would make one observation regarding antidotes for NOACs. These drugs have a very short half life and in fact despite what you might think the risk of taking them is very small. There are ways of dealing with bleeds like transfusions etc as well.

    As I have said before, the warfarin antidote thing is really a red herring as it isn't instant anyway. Although it exists it is tightly controlled and at HRC last year we were told that unless you were in a hospital it was unlikely to be available and then it would have to be prescribed from the pharmacy and we all know how long that can take in hospital. Vit K injections do take time to work.

    The bisoprolol is just to keep your heart rate down.

  • Quit worrying.

    My cardio told me that I have a 2.2% chance of a stroke (same as you). I'm 66. With every 5mg apixaban, my chance of a stroke goes down by 0.7 percentage points. That means 5mg/day -> 1.5% risk; 10mg/day -> 0.8% risk. So, on one hand, taking 10mg/day cuts my risk by almost two-thirds. On the other hand, two-thirds of a small number is a small number.

    I quit apixaban (5mg 2x/day) because:

    - no antidote

    - risk of bleeds

    - high cost ($4,800/year in the US, cost to me $600)

    I won't take Xarelto because of the extensive side effects.

    I took Pradaxa for less than a month - quit because of the very painful heartburn.

    Your chance of being hit by a bus crossing the street is probably greater than 2.2%. Enjoy your life.

  • Hi, just wondering what the "extensive" side effects of Xarelto are? I have been taking 20 mg a day for a year now and have had no side effects at all! I take mine after my evening meal.

  • You can check them out here:

    drugs.com/sfx/xarelto-side-...

  • Yes, that's quite a list, but they are POSSIBLE side effects. It doesn't mean everyone taking that medication will experience all or even some of those effects. I guess it is a matter of 'suck it and see'. I can only reiterate that so far, I don't seem to have any side effects from xarelto. Mind you, neither do I seem to have any side effects from the Bisop, apart from more dreams. But, it all boils down to each of us seeking professional advice and then doing what we believe to be best for ourselves and, as you said, "enjoying our lives".

  • Thank you for all your replies. I did particularly like the comment by Kodaska stating that my chance of being hit by a bus is greater than my stroke risk of 2.2% certainly bought a smile to my face and also helped me see things in a different perspective.

    Regards

    Roger

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