Any Apixaban Interaction with high fruits and veg intake?

[redshock11]

Anyone taking lots of fruits and vegatables when on apixaban and noticed any interactions?

[etheral]

No, that would only apply to coumadin which is countrecres by Vit k found in those fruits and veggies

[Finvola]

No, but I understand grapefruit should be avoided. Since being diagnosed with AF and starting Apixaban, I have doubled the amount of fruit and veg that I eat, without problems.

[Barb1 in reply to Finvola]

Why should grapefruit?

[Finvola in reply to Barb1]

I was not told to avoid grapefruit 5 years ago when I started Apixaban but I understand that others have been advised. This link may explain it:

webmd.com/drugs/2/drug-1630...

[redshock11]

In wiki, i just looked at the clearance pathway of apixaban: 75% via cytochrome p450 etc. with remaining 25% via renal. Then i looked at p450 pathway in wiki, there are not just affected by citrus fruits, but the phenolic compounds in fruits and vegetables. So i think this is an area that there is not enough research done. If the phenolic compounds from fruits and vegetables intake are enough to interfere significantly enough, the result will be higher than desired amount of apixaban in the blood.

[BobD Volunteer]

Simpkle answer is to avoid Wiki in my view. Trust your doctors.

[Auriculaire in reply to BobD]

Doctors tend to know very little about nutrition in general let alone details about the vitamins /minerals/ other micronutients in food. When hospitalised for my first afib attack and told I was being put on an anti vit k antagonist , I asked the cardiologist's underling ( who was a doctor but had not yet made it to the rank of consultant) if this antagonised K2 or K1 . If K2 would that then affect calcium deposition in the arteries and breast tissue. He hadn't a clue- didn't seem to know that there were various forms of vit k and which one was involved in the clotting mechanism. This did not stop him from being an arrogant individual who castigated his med student underling when doing the echocardiogram because the poor sod could not find my heart! Then after rudely snatching the probe out of the poor student's hands to do it himself he could not find it either.

I have been misdiagnosed or poisoned too many times in my life to trust doctors very much.

[Bagrat]

The trouble with wiki is that anyone can edit regardless of knowledge apparently.

[WendyWu20]

I eat a diet consisting mainly of fresh vegetables/fruits/salads. I was also concerned that I had a lot of Apixaban in my body, because even when forgetting to take a tablet, if I cut myself it looked like a scene from a horror film.

I now only take half a tablet twice a day (unless I have an AF episode, then I take a full one for a couple of days). I am not recommending this for anyone else, by the way.

I wasn't overly concerned until I lost a lot of weight last year, so I think the 5mg dose may be too much for me although I still weigh more than 60kg. My hair started falling out again after I lost weight, and I think it was the Apixaban dose and/or eating more veggies.

[redshock11 in reply to WendyWu20]

If your hair fall out from losing weight, it could be due to a dietary deficiency from a calories restricted diet.

From a scientific point of view, it seems there is not enough research on the way apixaban's concentration could be affected by various factors like body weight, dietary intake that may affect apixaban detoxification rate. The benefit of apixaban lies on a very thin line of shifting blood coagulation status towards the thinner end, so any unforseen circumstances that are missed out could be very dangerous. No doubt it should be safer than warfarrin but i certainly hope to see more detailed instructions from more research to make it safer for users. I will surely ask the senior cardiologist on this the next time i get to see him.

[WendyWu20 in reply to redshock11]

No the hair loss is very specific to when I first began to take Apixaban. Started falling out within one week, then eventually eased off after about 6 months. Then it began again once I'd lost a few stone and I reckoned it was due to a lower body weight and having too much Apixaban.

[Hidden in reply to WendyWu20]

I stopped taking apixaban as I weigh just over 60kg and on the whole pill dosage, kept getting bruises and the odd nose bleed which was more worrying than the occasional episodes of AF which never last more than a couple of hours at most and thus can't do much in the way of causing a stroke. My hair has got thinner etc since the menopause which I understand is quite common.

[WendyWu20 in reply to Hidden]

Quite a few people have reported hair loss when taking Apixaban. I wondered why some people get this symptom and some don't. Perhaps when you look at other factors, such as a high veggie intake, it may help to explain it. It makes sense really...most of the stuff I eat such as leafy greens, citrus and onions/garlic etc are known anticoagulants. If you eat this stuff as your staple diet (like I do) then it must all add up.

Have you considered taking the lower dose of 2.5mg? I feel happier on this, although I still get the 5mg tablets in case I go into AF.

[Hidden in reply to WendyWu20]

I have always eaten a diet with a high vegetable and fruit content, as much organic as possible and have not eaten meat for many years. I have been mainly dairy free for some time now, make my own bread from organic wholemeal or spelt flour and am pretty annoyed to get this PAF after years of healthy living.

I did consider taking the half dose of apixaban but the cardiologist didn't like the idea of that and said that I had a 2.2% chance of having a stroke- I replied that I thus had a 72.8% chance of not having one and preferred to be positive. I was told by an EP that AF is not likely to cause a stroke unless episodes are considerably longer than mine ever are.

I also eat plenty of garlic and onions and greens and didn't know before that these were natural anticoagulants- so thanks for that info. I remember when in Israel many years ago, I was invited to a Friday night meal with a Yeminite Jewish family. Garlic was eaten in abundance with cloves strewn along the centre of the table and the idea was to dip a clove in a paste made of more garlic and other things before eating it! I tucked in, not wishing to be impolite, and greatly enjoyed the little performances that the children gave after the meal (many of the dishes seasoned with garlic). The next day, I felt as if I were a dragon breathing fire but I understand that the Yeminite Jews have no heart problems. They only over indulged in the garlic on Friday evenings as they knew that on the following day, the Sabbath, they would only be among others who had done the same, so would not offend anyone with their breath!

[redshock11 in reply to Hidden]

U have just pointed at a statistic that i previously found need further investigation but did not bring it up because of concern of confusing others. 2.2% more chance of getting a stroke!

The way fruits and vegetables work to thin blood besides having a natural asprin substance (research find it very hard to quantify accurately) could be also due to their content of inhibitors of detox pathways like the cytochrome450. In short, natural food tends to have an arrays of substances that work in a synergetic, longer lasting and more stable manner as opposed to the "magic bullet" approach as in the case of noac which targetted at a single biochemical reaction. I hope to see more research in this area. By the way the patent of apixaban seems to be running out in a year or so i think.

[Hidden in reply to redshock11]

Thanks, all very interesting - good to do our own research too as it gives us a feeling of some control over our problem!

[Jjda]

This is very concerning to a non-meat eater! I am going to quiz my cardiologist and my EP when I see them next, and tell them that they need to press for answers, since the drug companies will obviously not advertise that information, and not everyone they are prescribing for eats chickens, cows and pigs.

[Hidden in reply to Jjda]

Sheep ok? (-:

[Jjda in reply to Hidden]

Sheep over here is too expensive!

[Carol70]

Since taking Apixaban, I have eaten high volumes of fruit and veg with no problems at all. I don't like grapefruit, so that is not an issue for me. Some meds do indicate that small amounts of grapefruit are ok but not taken at the same time as the meds.

[lacolyn]

I don’t eat meat, 3 years now, and post ablation on Apixaban. I eat a reasonable amount of veg and fruit and am not aware of any reaction.

[RoyM]

I have been a vegetarian for 20 years...taken Apixaban for 6 years with no issues.