Diarrhoea and Rivaoxiban

[CyclingMad]

I had a cryo-ablation last week and was put on Rivaoxiban. I've had terrible diarrhoea from the day afterwards. I've read that this is a common side effect. Have others experienced this? Have you found one of the other drugs a better alternative? 

[Buffafly]

I had diarrhoea after my ablation but the reason is still a mystery. I was already taking Rivaroxaban but before the ablation I was also taking two meds that caused constipation so hard to tell. 

[gemsmum in reply to Buffafly]

Yes I had diarrhoea when I started taking Riveroxaban and had to stop and change to Apixaban and no problems since, been on it now for just over a year, hope you get sorted soon, best wishes

[CyclingMad in reply to gemsmum]

That's encouraging news. I'll explore that option with my GP and consultant. 

[Alan_G]

I'm not familiar with these new drugs. As a relative newcomer to this, does this mean warfarin is no longer the drug of choice for these conditions?

[CyclingMad in reply to Alan_G]

I'm no expert either but Warfarin needs far more careful and formal monitoring to get the levels right. My consultant is switching me to Apixaban straightaway and hopefully that will be the end of the diarrhoea problem. If that doesn't work then Warfarin is the fall back option. 

[Alan_G in reply to CyclingMad]

Okay. What I did read once was that you can be quickly taken off Warfarin if necessary, but it can take longer to get blood clotting working again on some of the newer drugs, say you needed a emergency operation, for example.

[CyclingMad in reply to Alan_G]

I'm afraid I can't common on this but perhaps others can. 

[PeterWh in reply to Alan_G]

Not true as I understand it.  for instance Apixaban has a short half life and that is why you have to take it twice a day.  The half life of warfarin is very much longer (I think 2 or 3 days).

[PeterWh in reply to Alan_G]

Just thought about another point.  If you did need an emergency operation then they have ways of dealing with bleeding anyway (and that also applies to those on warfarin or not on any anticoagulants.  Also nowadays some EPs like to have an INR either between 2.5 and 3.5 or between 2.0 and 3.0 when they are doing an ablation - and that would mean that the holes they make in the groin and through the septum in the heart take longer to heal.  (ie they NO LONGER automatically stop anticoagulants for up to 5 days beforehand - some consultants still do).

Also now I was personally told that for some other minor operations, dentistry, etc they NO longer stop anticoagulants for up to 5 days beforehand (or even the night before) because they believe that the risks of not being anticoagulated are FAR HIGHER then the risk of bleeding.  As one said to me it makes no difference if you lost 100ml of blood because you were on an anticoagulant whereas you would have lost less if not.

[Alan_G in reply to PeterWh]

I saw the article some time ago and there's no saying when the article was written so I guess the new drugs have come on a bit since then if they are now just as good as warfarin. Is it accurate to say that GPs will recommend warfarin still on the NHS because of cost alone?

[PeterWh in reply to Alan_G]

Some might because of cost.

However some might because they know little or nothing about the NOACs because they are not informed. 

[Perrylees]

Well... I had some diarrhoea when I first started on apixaban! Sorted itself out after a little while.....  I have literally just ( today) changed to a high dose of rivaroxaban as I have a couple of small clots in my lung  ( nothing to worry about but had ablation last week & I think  the Drs are being super cautious).  I REALLY hope no diarrhoea though 😳😳

Ruth 

[CyclingMad in reply to Perrylees]

Let's hope both of us are lucky this time!