Apixaban

I'm on apixaban post ablation and read that it's out of system after 12 hours, hence needing to take it 12 hours apart to be covered..... how about now the clocks have gone back, is there a potential to be non anti coagulated for an hour..... I know it isn't much but just eondering

[rosyG]

I'm on Apixaban and although the half life is 12 hours I think an hour is OK- otherwise we wouldn't have to stop 24-48 hours before operations if it completely left the system at 12 hours. It is important to take every 12 hours of course

[PeterWh]

Agree with Rosy. You could always adjust by 1/2 hours today ahem same tomorrow if you feel the need. However what did you do this morning?

[Hidden in reply to PeterWh]

Took it at 8:30 like usual, which means an hour late, was just wondering really

[Hidden]

Don't think it's out of your system, it's half life is twelve hours, so it's just down to half its potency. I'm not medical, just googled it.

[BobD Volunteer]

You worry too much Juggsy. Relax an hour isn't going to make any difference.

[beardy_chris]

I've asked a number of medics about just how accurate do I need to be with the timing of taking my drugs in the past. The best answer I've got is to aim for the same time each day; +/- 2 hours is okay with only a marginal increase in risk; +/- 4 hours is about the maximum variation that is sensible. Remember though that anti-coagulants are about reducing the risk and you aren't going to instantly have a stroke if you are late taking them or even if you miss a dose entirely.

However, of course, it is best to keep on taking the drugs at the same times each day.

[PeterWh in reply to beardy_chris]

Unfortunately some medics rush into things based on past experience

It really depends on which drug. It will depend on the half life if the medicine and the frequency with which it is taken.

For something like warfarin that, in my opinion, works fine particularly as warfarin is a slow acting medicine and stays in your system for quite a long time and operates on the reservoir principal.

For something like rivaxoban that Still might work ok but is pushing its limits since the half life is i believe 24 hours.

With apixaban I don't think that is at all appropriate since it is taken twice a day and the half life is 12 hours. If you took it 4 hours early then at the point soon after taking it your levels will certainly still be safe because it's a medicine that can be double dosed for a week in the event of a clot so the higher level is ok. However taking it 4 hours late means it's effectiveness has diminished. However with the scenario of 4 hours early one dose and 4 hours late the next dose means you have a 20 hour gap. I was on apixaban initially and I can't remember which medic told me this but it was to be taken within an hour window. I'm not sure if that's time + or - 30mins or time + or - 1 hour. I suspect the latter. I still have the leaflet from 2 years ago and interestingly it says if you forget to take it then take a tablet as soon as you remember and then take the next tablet at the usual time then continue as normal.

I'm using some of the analysis and logic techniques used for work on here because I'm not medically qualified.

[beardy_chris in reply to PeterWh]

I asked the question specifically about apixaban. It is, of course, better to avoid wild fluctuations and I certainly don't think my advisor was suggesting one dose four hours early and the next four hours late would be sensible. You are right, an hour here or there is probably a better guideline.

[Hidden]

Thanks, it was merely a question about us brits and the clocks going back

[Carol70]

Interesting point juggsy 75, I hadn't given this a thought, just took mine at usual time - 6.30am and 6.30pm. I suppose the same thing occurs in March when the clocks go forward.

[Hidden]

Yes, but it's only is brits it affects😂😂

[PeterWh in reply to Hidden]

Many other countries also change their clocks including America, Canada, the whole of Europe, Australia, New Zealand and many others. In the last few years there have been quite a few countries who have switched over to changing their clocks!!

[Hidden in reply to PeterWh]

Well everyday is a school day peter👍👍

[PeterWh in reply to Hidden]

Thought that would amuse you since you are supposed to be doing nothing!!!

I don't expect you to go through every country to find out which do and which don't!!!

[Hidden in reply to PeterWh]

I am dissapointed in myself that I didn't know USA was one, it's our favourite holiday destination

[PeterWh in reply to Hidden]

There you are!!!

In fact with regard to the US we have four different time "zones" in the year as they move them forward on the second Sunday of March and move them back on the first Sunday in October.