I must say that after my swift swop from warfarin to apixaban, i am just starting to feel the benefit of an unrestrictive diet. As you all know, i was more than happy on warfarin and didnt feel as if I allowed it to rule my diet, but I now realise that I must have curtailed my natural way of eating somewhat. It is great to be able to have extra portions of veg, 2 salads in one day, and........cranberries!

One question though.......

On warfarin and being a self tester, i could easily see if I was ill, that my I.N.R. had gone up and I could make adjustments. Similarly, if i exercised a lot and my I.N.R. went down.

I know that apixaban works on a different clotting factor but is the level of it in your blood affected by these things and if so, does that mean we could be under or over anticoagulated without knowing.....any ideas?

8 Replies

  • These NOACs work in quite a different way and unless you are ill and "reject or eject" the tablets you are covered. There is no way of checking levels because they work. End of.

  • dedeottie - I admire your ability to see that silver lining and hope you are feeling generally better.

    Regarding Apixaban, which I have taken for two and a half years and have never taken Warfarin, I assume 'in my innocence' that it does what is says on the label. There are now so many patients taking Apixaban that problems such as you describe would surely have come to physicians' notice by now. Enjoy your new-found freedom, cranberries, veggies and all!

  • Hi. I am trying to see the positive s in tbe situation otherwise I am afraid I may crack! The really great thing is that I trust my E.P. and my G.P. and so I do feel looked after. I trust that they will come up with a game plan for me. As for apixaban , i guess I am going to have to trust that as well.

    Hope all is well with you. X

  • I would suggest you ask your Chemist this question, not your Doctor. J.

  • It is not so much a question of not having to monitor the NOACs but not being able to. Testing is a long complex procedure with the NOACs that can only be done in a laboratory. In assays, the blood level of NOACs has been shown to vary a lot and the simple answer is no one knows whether some food affects the blood levels or not.

    Having said that they do provide a more consistent level of anticoagulation than warfarin. However warfarin's big advantage is that it can be tested and well controlled warfarin (i.e. more than 90% in range, which is achievable with modern methods) is superior to the NOACs.


  • Thanks for that . Interesting and it is what I thought. I am seeing my consultant in 3 weeks time and will be discussing the whole thing when I know more what his future plans for me are. X

  • Dedeotti hi ,I've been on Apixaban 14months now,as far as I'm concerned it's the best thing that's happened to Anicoagulants! It is widely used in Europe,here in UK it's seen as a new drug! Mainly because of the price!

    Warfarin was the only anticoagulant when I was nursing,Apixaban is seen as a safer drug,together with the other NOAC,s !

  • Thanks. It is reassuring to know it has actually been around for a while. X

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