Apixaban and what now?

[Murd]

I've just been put on apixaban.....a bit scary and not sure if I should start taking them??? Looks like once you start you can't stop taking them.

I haven't been given any advice by my dr on how to manage this drug.

Any advice would be welcomed.

[Hidden]

Hi I take one of the new anticoagulants. Been taking it for a few years. If it prevents me having a stroke I'm all for it. I have a yearly blood test to check liver/ kidney function and feel ok with it. What are your reservations?

[Murd in reply to Hidden]

Hi,

my reply seems to have disappeared - perhaps my rambling was not allowed by the moderator or my putting a link to the peoples pharmacy website which has a lot of negative posts about Apixaban. Most of which scared the pants of me.

[Finvola in reply to Murd]

The purpose of those negative posts on that site was to scare people, in my cynical opinion, Murd. To be honest, it looks like an unscientific rant in many of its points.

The bottom line is that our medical practicioners have advised us to be anti-coagulated and in the millions of daily doses, there are bound to be some problems for some people. It's all a matter of risk balance and choosing the least risky path through life.

[Jfib in reply to Murd]

Hi Murd;

I just checked out the people's pharmacy site. Please don't scare yourself with those articles. They are VERY alarmist. I've done a lot of reading about Apixaban, and what they are reporting... well it's very fringe information, and rather biased if I may say so.

[Hidden]

Shouldn't be a problem Murd as many of us here on the Forum take Apixaban or one of the other "NOACs". The medication will come with lots of information and assuming you are not over 80 yrs old, you will be probably be taking 2 x 5 mg pills per day. It's true, most folk taking any anti-coagulant will have to remain on them for life, but virtually everyone considers that is better than the alternative.....the risk of having a stroke!! Unlike Warfarin, you do not need regular INR tests, but you should have a blood test after three months to check that your kidney and liver functions are OK and then annually thereafter. Side effects are rare for most people and apart from grapefruit/juice, there are no food restrictions but I would urge you to check this out for yourself, either on the AFA webpage or via Google as we are not medically trained......best of luck, John

[Murd in reply to Hidden]

Thanks for that - see my reply to "frills".

Saves me pasting the same rambling reply to yourself.

[Hidden in reply to Murd]

Didn't see reply but not to worry

[BobD Volunteer]

I would rather take anticoagulants than risk a stroke. If you have been assessed as at risk then why argue?

Read all about anticoagulants on AF Association website where there is a wonderful dpwn loadable booklet.

[Murd in reply to BobD]

Not going to argue with the diagnosis, just need to know if i am on the right meds.. warfarin or Apixaban or one of the other drugs for AF.

I don't know when to take them - twice a day -is that morning and evening or at a specific time?

don't know what not to take with them

Can i go to the dentist to get an extraction?

What happens if i have a nose bleed?

Will i have a stroke because i have missed a dose, because of crossing time zones, like to Australia to visit my daughter - can i even fly????

I don't know the answer to these and many other questions.

I think i need to get another GP when i read how other people have been given advice from their GP...

[KFog in reply to Murd]

Hi Murd,

I am not a doctor. Twice a day to me is morning and evening. I have been on Apixaban for a year now, and that seems fine. Take them with water, if that's what you usually do. Tell your dentist you are on Apixaban, and he or she can figure it out. I don't get nose bleeds, but I suspect that they will last a little longer than they usually do. Minor cuts take a little longer to heal. Don't sweat missing a dose, but start taking it right away when you remember. If you're traveling across time zones, try to plan to evenly space your doses until you are settled in the new time zone. You should be fine to fly and keep enjoying life if you are feeling fine.

I hope this helps. It is just my experience.

[Murd in reply to KFog]

Thanks. that's very reassuring. beginning to feel less panicked about my future.

[Walker1234 in reply to Murd]

Hi

I take Apixaban one in a morning an one last thing at night..been fine on them

[Finvola in reply to Murd]

Hello Murd - I have been taking Apixaban for over three years and would say the following as my experiences:

I take it at 9am and 9pm

Missing one dose is unlikely to cause a stroke but try not to miss

I've had a large dental extraction and the dentist followed his normal procedures for anti-coagulated patients

Nosebleeds (and any other minor cuts) take about twice as long to stop - grip nosebleed for about 20 minutes

Avoid aspirin, NSAID's, St John's Wort and grapefruit

Foreign travel and time zones have to be managed so that your doses are as evenly spaced and convenient as possible

You will need a kidney function blood test at least annually.

It's all a bit of a learning experience.

[Murd in reply to Finvola]

Thanks Finvola,

So they don't bleed forever..... I know that sounds silly, but in my head when I read about no antidote being readily available, I imagine the worst.

Should I have appointments for anything else, like coagulation clinic or electrophysiologists etc.

think I need to see the GP again, but armed with questions.

[Rellim296 in reply to Murd]

Relax, and don't worry too much, Murd, about the bleeding. Anticoagulated blood just takes longer to clot and if you cut yourself you will find out that it's not hugely different from normal. If things are dire and you sever an artery you are in trouble whoever you are and normal people can die if an injury is bad enough but this doesn't really bother anyone a great deal as it so rarely happens. If you are on an anticoagulant it will take longer to control a bleed but the famous Warfarin antidote is unlikely to work fast enough to make much difference and I certainly don't feel at a disadvantage on Rivaroxaban.

There are drugs available for anyone haemorrhaging although a doctor trained in their use needs to be available.

Warfarin needs trips to the coagulation clinic to check how well it works because it is affected by all sorts of things and one's level of anticoagulation can vary. Apixaban and the other NOACs provide a much steadier level of protection with very few dietary issues.

An electrophysiologist is the expert for anyone with AF and your GP can refer you. As Drounding says, your pharmacist may be able to help too, as will your GP.

[Finvola in reply to Murd]

I agree with Rellim - try not to worry, but we all have! Being anti-coagulated doesn't mean that your blood will never clot - it does, but more slowly (usually twice normal). No antidote is a bit of a red herring as everyday incidents are usually manageable.

Read as much as you can on good website such as the AFA through the following link:

heartrhythmalliance.org

I think that a cardiologist who specialises in heart rhythm disorders is essential to find the best course of management for AF and your GP is your first port of call there.

Best wishes

[Mazza23 in reply to Murd]

I live in Australia no probs with apixaban just keep your watch on english time and take your meds as you do in England

[CDreamer in reply to Murd]

X2 a day = every 12 hours. Apixaban has a short lifespan - that means it becomes ineffective after 12 hours.

[Plai in reply to Murd]

Talk to your pharmacist. They should have a leaflet specifying dos and don'ts. Twice a day means one every 12 hours not all at once. The leaflet in the apixaban box is also worth reading. You will soon get the hang of what you can and can't do!!

[10gingercats]

I was given Warfarin and then later chose Apixaban after a very small TIA.I feel fine on Apix. no side affects.There are plenty of knowledgeable people on this site so you will be well supported. Try not to worry and 'keep taking the tablets'.

[Murd in reply to 10gingercats]

Thanks.

I was told by my last GP before i moved house to another area, to take Magnesium for leg cramps and a multi vitamin - been taking this for a few years now, but don't know if it goes with Apixaban - been told not to take grapefruit by "flapjack" - sounds like there may be a list of things i must now be careful about.

[10gingercats in reply to Murd]

I take Magnesium with GP's ok.No grapefruit due to taking verapamil.Grapefruit was not mention re. Apixaban so I do not know.

[Jfib in reply to Murd]

Hi I just started Apixaban a few weeks ago, and I must say it's been much better that I thought it would be. I was so terrified that if I cut myself I would bleed to death, (lol, silly I know). So far no bruises ( a miracle for me), and what few scratches and scrapes I have had, pretty much stopped bleeding normally...maybe a few seconds longer. But not much. So, yay!

Also, I consulted my pharmacist. I can still take my multivitamin and b12 supplements, I just have to avoid the things that the others have listed here (st johns wort, grapefruit, aspirin, etc).

Try not to worry

[Hidden in reply to Murd]

No list Murd....just grapefruit as far as I know

[Plai in reply to Murd]

No anti inflammatory tablets either like ibuprofen.

[Drounding]

You should be OK with Mg and a multi-vit. You can always check with your pharmacist if you're in any doubt. I take Pradaxa (Dabigatran) as well as many other drugs including Mg and Vit D3 without any problems.

[Murd]

Thanks that's useful - didn't think of having a chat with the pharmacist.

[Annekw]

Your pharmacist will become your best friend! They are very knowledgeable about drugs plus interactions between drugs.

I've been on Apixaban for 2yrs - no problem!

[CaroleF]

Can't add a great deal more to all the helpful info. etc that you have already been given except to say that (a) I think everyone here knows how worrying it can be when first taking a new medication and (b) being as well-informed as you can is a big help in allaying initial worries.

A pharmacist is very likely to be the person best able to answer any questions (especially the practical ones) you may have about a drug. Furthermore, you can usually just pop in and ask without waiting for an appointment. (Currently 3 weeks for that at my GP surgery - unless it's an emergency!) As someone has already said .... make him/her your 'new best friend'.

I take apixaban and so far no side effects, bleeds etc at all AND I am much more concerned about the risk of a stroke (likely to be a serious one) than I am about the risk of a bleed.

I do hope you will take some comfort from all the replies to your initial message.

[rosyG]

It's very easy to deal with- Just make sure you set reminders to take at the correct time twice a day- that's important. There are a few drug interactions so you need to check when taking other medicines-you need to have kidney and liver function tests from time to time- depends on your health as to how often but your GP should advise on this.

You will need advice before any surgery as to what to do- the hospital would advise here.

Good luck!!

[foxglove1]

Hi

I have been on Apixoban for almost a year now with no problems at all.

I do not take any other medication and went through all the anxieties that you have mentioned.

I hated the idea of medication and still do, although the alternative is far more frightening i.e. a stroke. Ive cut my fingers while cooking and have not noticed I bleed for longer and have had no nosebleeds . I have also travelled to India in November with three internal flights whilst there No problems.

Hope this helps.

[souljacs4]

What ever questions you have someone will try and answer them. there is also a search box top right hand side and some of the things you need to ask may have already been answered for instance if you type in Apixaban you will see previous posts on the subject. I found it very helpful.

[Mazza23]

I have had apixaban for three years now no problem will take them for rest of my life would rather take them than have a stroke trust me

[Hidden]

Been on it for a year no problems, no side effects. A stroke worries me and I am very happy to take this drug.

[CDreamer]

I have been taking for 6 months absolutely no problems, far less side effects than other anticoagulants - which I stopped taking 2 years ago after ablation - very much depends upon your circumstances as to whether or not your can cease taking ACs,

Far safer to take than not if you have AF as it helps protects you from stroke - which is the major concern for people with AFl

[dizzielizzie1]

Hi Murd, when I got to 65 I was told I needed to be on an anticoagualnt, because of my PAF, but I put it off for months , because I had done lots of research and was nervous about the side effects of the NOACs. My GP said that it was really down to me whether or not I took them, but a friend who was a consultant haematologist said I really should take something, as my stroke risk was much higher than average, so I gave in and started them. I take Apixaban once in the morning and once at night. I feel Ok on it. Don't fret. When you feel happy about everything, just start taking them. Your doctor ought to have discussed the pros and cons with you before he prescribed them though. Oh, do remember to carry the card which comes with Apixaban. Keep well.

[Murd in reply to dizzielizzie1]

Thanks

Good to hear from someone else who was nervous about taking NOAC's.

Makes me feel less foolish and more likely to get on with it.

I suppose what I needed was some confidence that the new NOAC's were safe and didn't come with a lot more problems. The other website I looked at was full of horror stories. I was also getting lots of info that I should just take various vitamins and minerals instead, as that was what was missing in my body and creating the Afib.

[nettecologne]

I did not manage well on Apixaban or any of the new NOACs. But that does not mean you won't. I'm glad I tried, though.

If there are bad side effects in your case you can change to another one, that is always possible. And they can be stopped, no it's not a lifer. People get this for clots too and then usually for a short period (6 mths or a year) and then stop. So any decision you make now is not for life.

[johnk1956]

Hi Murd, I took them for 3-4 years while in AF, had vats ablation in October, was advised to stop Apixaban in January if still in rhythm, I'm 100% clear of AF and now only on 2.5mg of Bisoprolol. Happy days, so not need to worry, they are not necessarily permanent.

[Geza10]

i have taken it for 2 years now play my 7 a side indoor footie full contact been kicked and put down on the floor no bleeds or bruises

[JaneFinn]

Hi Murd, totally get your concern. When my GP wanted to put me on anticoagulation, I googled apixaban and rivaroxaban and couldn't believe the frightening stuff that was coming up on the People's Pharmacy, and other places about deaths and mega lawsuits in the US.

TBH once I've been that freaked it's hard to get it out of my head. But my GP was great - he saw me three times simply to go through my questions and fears - and ultimately he scared me into taking them by pointing out how much greater my risk of stroke was. (And a horror story about an AF patient of his who had procrastinated over whether to take and then had a devastating stroke.) My GP said he is confident enough in these NOACs that he wouldn't hesitate to take them himself.

So I went with it (rivaroxaban - though I'd like to switch to apixaban) and 4 months on it's all good. And I've found this site which is WAY more reassuring and informative than anything else! I've had some humdingers of bruises once when I slipped over - truly spectacular- but nothing to worry about

The advice and comments everyone has given you above are brilliant, nothing I can add. I just wanted to empathise with your fears and add my reassurance.

Be well

[NooNoo14]

I was on it for a while before changing to Warfarin due to another medical condition. I had no problems - just remember to take it as instructed in the leaflet and you will be fine.

Annette

[Saffy83]

I have just been put on Apixaban. I have a pacemaker and had ablation to heart for super ventricular disease back in 1992 I also have a atrial flutter. I was very scared to start this medication. I realise that I needed to take something when the Cardiologist hilighted it! I am in my 60s so it is time to start guarding myself from a stroke..