Lower dose of Rivaroxaban

[Mrspat]

Question for those currently taking Rivaroxaban: is everyone on 20 mg daily and is there anyone here who has been on 20mg and had it reduced? I understand that 15 mg and even 10 mg can still be effective for stroke prevention in AF.

Background to this question: I recently had a pre-op (tear duct procedure) blood test. The result has come back that my creatinine (kidney related) levels are “slightly elevated”. My GP has been advised. My last kidney function test was a few months ago and I heard nothing afterwards.

Also of relevance: I have only one kidney, probably since birth. I have lost about 20lbs in weight (deliberately) in the last year. My AF is rate controlled and I feel extremely well.

I am waiting to see whether my GP sends for me. Early in the New Year I have both a cardiologist appointment and one with the eye surgeon. It would be useful to have an informed discussion.

Thanks and a happy festive season and New Year to all.

[Nanfranz]

I was put on Xarelto (Rivaroxaban) about 18 months ago -- given 3 months supply of 20 mg. Three months later I needed a prescription refill, but happened to casually mention to cardiologist how expensive the drug is, and he gave me six weeks of free samples -- much appreciated! When I noticed that the samples were 15 mg, not 20 mg, he said they were all he had on hand but "15 mg should be just fine." Which made me wonder why he put me on a higher dose to begin with, though maybe my apparently "very brief" AF episodes have something to do with that. Anyway, I've been on 15 mg ever since, assuming that I'm adequately protected. So far so good. My experience doesn't give you any real insider info or guidance, Mrspat, but thought I'd offer it for what it might be worth. Will be most interested to hear any followup you might share.

[Hidden in reply to Nanfranz]

Hi Nanfranz. I may have misinterpreted, but do you pay for your prescriptions? If you're in the UK and have a drug to take permanently I understood that you could apply for an exemption certificate to get them for free.

Hope this helps but ignore me if I've got things wrong.

Have a great Christmas.

[Nanfranz in reply to Hidden]

Thanks, Minimalist, for your suggestion. I appreciate your thoughtfulness! I'm in the US and have a Medicare supplement insurance which does help pay for prescription drugs. The cost to the consumer depends on the medication -- for example, one of my maintenance prescriptions costs me only $12 for a three-month supply, while Xarelto and Olmesartan each cost $150 for three months. The snag is that the insurance keeps track of what you and they combined have spent in the current year and when it reaches a certain amount, then you're on your own until the end of the year, when start with a clean slate, so to speak. Last year and this year have been my first experience of being in the Medicare "gap", when I was stunned to find that a three-month supply of Xarelto (enough to carry me to the end of the year) would cost me $500 (instead of the $150 I was expecting to pay)!

All the best to you at this special time of year!

[Jill13]

I am in permanent AF but on heart rate not rhythm control drugs which make my symptoms virtually disappear and according to my cardiologist have less side effects. I was started on 20 mg of xarelto but now reduced to 15 mg Cardio didn’t really say why but may be because of my age, 78 in Feb.

He also wants me to have regular liver and kidney tests.

[Patient007]

I was on 20mg but the GP reduced it to 15mg because my gums used to bleed that much when I was on the 20mg I used to wake up in the morning looking like I was a Vampire and had been out all night sucking blood!. Being on 15mg is better than nothing though. I take it because I have AF. Happy Xmas and New Year.

[Sambaqui]

I think this is a really interesting question, Mrspat. If 10 or 15 mg is considered effective then why are the rest of us on 20? I would have thought that only the minimum absolutely necessary of any foreign substance should be introduced into the body. I wonder if there is any research and if anyone with medical knowledge of this issue reads Health Unlocked?

Good luck with your New Year appointments. I'm probably not the only one who'd be interested to hear what your cardiologist's view is, should you be willing to share.

[brit1]

this is why for now I am only taking 2.5mgs Eliquis 2xday. I saw that males 6'tall weighing 185lbs are on the 5mg that cardio recommended I should take. I weigh 145 (F) and altho 2.5 is supposed to be for up to 135lbs I am curious as to why it wouldn't cover my weight plus I will be 80 next year which is another reason 2.5 is often prescribed.