Testing blood when on Rivaraxaban - AF Association

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Testing blood when on Rivaraxaban

I have never been tested for level of coagulation since I have been on Xarelto.

Today I met someone who is tested every 6 months.

After being on Warfarine for years and having 2 weekly INR tests it did feel strange bring unmonitored.

Should I be tested? I ask because I have just had an eye haemorrhage.

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There are no tests for levels of DOACs . They work--end of story. What is tested is liver and kidney function where there are concerns. I have these anually regardless along with a range of other anual tests and am on warfarin although in range most of the time so INR only tested every six weeks or couple of months unless there is a change of meds.

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Thank you Bob

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One of Bohringer's own scientists was tactless enough to suggest that testing when on Pradaxa would make the drug safer. A test did exist which though not widely available could be made so. He was quickly shut up as the lack of testing was an important marketing point when comparing it to Warfarin. Given the number of older people who had significant bleeds when Pradaxa was first introduced and the slew of lawsuits in America that followed maybe the guy had a point.

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My undestanding is that the law suits stemmed from unwise prescribing in that people were not being vetted for suitability. As so often money rules and safety gets shoved under the mat.

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Ah but what constitutes suitability? If people were moved from Warfarin on which they were stable - and their stability could be verifed with testing their INR -they still might have benefitted from testing with Pradaxa. My ex GP in England is a personal friend and we keep in touch regularly. Her husband developed a DVT in his leg and was put on Apixaban. He subsequently developed a pulmonary embolism. She took him privately to see a leading haematologist who changed him to Warfarin and told them he did not like his patients to be on NOACs as he considered Warfarin to be safer because of the testing and because the NOACs just had not been around long enough for the possible bad side effects to manifest themselves.

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I think one or two people died because of liver failure who already had diseased livers but were still given one of the doacs. Money before care again. Doctors sued for malpractice? No go after the Pharma it easier. Thank goodness we don't have that culture here-----yet. lol

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I was thinking!! Continuing the topic of the non testing of Rivaraxaban etc.

You say they work, yes they do.

But, it is not a blanket prescription is it? There are different doses. How do they know that that set dose is beneficial all the time. What do they base the amount on? I would have thought that so many things life, time, illness , diet etc would alter our body , and affect it’s reaction to the drug.

Just a query.

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Any reduced dose is due to body mass, age or kidney weakness. All other take same dose. Sorry been playing all day at Castle Combe. Had to come back the scenic route as M5 full of grockles.

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What is the norm dose then ?

I am Petite .

Gorgeous sunny weather.

Gardened ALL day like a maniac. What to do with 3 green things full of my hacking? But, feel so smug!

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For the benefit of our American readers can you give is all a definition of a grockle Bob?

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Grockle (Grok-ul) Noun. Human version of a lemming . They invade our lovely county (Devon) every bank holiday driving overloaded vehicles adorned with surfboards usually towing caravans and make local travel impossible. Term also used in Cornwall. Police have been known to turn some away when grid lock finally takes place especially near coastal villages where emergency vehicles are blocked. Poldark and similar TV series featuring picturesque fishing villages are catalyst for catastrophic growth in population. Also provide useful food for our greedy tourist industry.

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I have liver and kidney function tests every six months or so since I have been taking rivaoxaban. At one point early on my liver function was a little compromised and I was changed from 20mg to 15mg rivaoxaban per day, no further issues since. Ask your medic if concerned and in light of your eye haemorrhage. Best wishes.

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Thank you for sharing your experience meadfoot. The enzyme which is elevated in my liver is alkaline phosphatase and I’ve just checked . . . Apixaban can raise it. Hopefully, that is the reason as the other causes aren’t so straightforward. Glad you got your problem solved.

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My alk phosphatase was raised in Jan (I'm on apixaban) repeated Feb down a bit, ditto a week back by a very small amount. Finvola has it been suggested you change DOAC or return to warfarin. I've just been told I'll have another test in 3 months. Where did you find info re apixaban as I had a trawl and couldn't find anything apart from this livertox.nih.gov/Apixaban.htm which is not a good fit as I've been on it for over a year. Having said that no blood test for a year after starting it and only renal function prior.

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Bagrat This has just become an issue at my latest test on Monday, so I haven’t talked to any medics yet. The test is to be repeated, together with a bone profile test - eliminating the medical reasons, I suppose.

I checked through my test results since starting Apixaban in Jan 2014 and the alk phos readings are consistently elevated. The last reading is slightly higher than any at 157, so I assume it has triggered an alert to the doctor. My thought is that it could have gone up slightly on starting Apixaban but not enough to cause concern.

These are two of the sites - click on the professional section and scroll down:

drugs.com/sfx/apixaban-side...

rxlist.com/eliquis-drug.htm...

Has anyone suggested to you that there is a chance of Apixaban causing this - apparently it is rare, between 0.1 and 1.0%.

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Finvola my last one was 151. Previous 158. Haven't spoken to my GP just got the online no further action which turned out to be repeat again in 3 months. Thanks for the links. As it's only a small rise ( no other oddnesses) I am not unduly concerned). Will be interested to hear how you get on. Was not asked to fast but did for last two as LFTs can be affected by food if you are in certain blood groups one of which is O+.

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Bagrat It looks like we are in the same boat - I had several readings going back to 2015 in the high 140’s, prior to this one. I too decided to go for the next test fasting, so it’s interesting what you say - my blood group is O+.

Will certainly let you know what happens after the next test on 5 June. Thank you for the information.

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Hi Finvola . I was on rivaroxaban 20mg for approx one year and was changed to apixaban. About 3 days later I had a haemorrhage behind my right eye. I still have a small blind spot years later. after the haemorrhage I was changed back to rivaroxaban 15mg and had no problems since, that was four years ago. I have routine annual liver and kidney function tests. As only one factor in your blood is compromised, as opposed to all coagulation factors with warfarin, it’s impossible to get any useful information in terms of clotting factors. What they have discovered is that 10mg will treat simple DVT and 15-20mg is sufficient for pulmonary embolisms and heart patjents. Sadly there are never any guarantees whether you are on warfarin or DOAC. I suffered two DVTs in my calf and was treated with warfarin. Despite the warfarin I went on to develop a pulmonary embolism. I remained on warfarin and four years later developed a second PE. It’s still important to take all sensible precautions to avoid a blood clot and never be complacent.

Good luck

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Good grief !!!!!

I will! Thank you.

Had to have a CT scan yesterday because my guts are playing up non stop.. Felt very sorry for myself! Even more so , because the radiologist was SO kind ! I don’t find this with my GP

or cardiologist.

L

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Yes we get quite emotional when a medic is particularly kind to us, guess it's pent up stress which we somehow release when touched by kindness. I too have the gut issues big style and am sure that in my case my gut and heart affect each other badly. Currently I am having a really bad time with both. Good luck for a good outcome. X

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Yes, I will phonevthe surgery.

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I’m also tested every six months but not to check on Apixaban but to check that liver and kidneys are processing and excreting the drug as they should.

It is advisable to have it done - I had my report yesterday and have a raised liver enzyme which is causing me to have a retest next month.

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I will phone the GO. In the meantime I edit for results of stomach CT scan which I had 2 days ago. Fed up with being told my long term gut problem is due to stress.

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I have a blood test yearly at my doctors

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I have been on Eliquis for a year now, and every day I seem to find a new reason to want to be off of it. My EP never mentioned liver and kidney problems, or increased incidence of colon cancer associated with Eliquis, and has not ordered any blood work. I went yesterday for my annual blood work that my Family practitioner orders, so we will see what damage has been done. I find out more on this site than I ever get from my doctors.

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That is true.

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Hmmm.... as others have said, you should have blood test to check liver and kidney function while you are taking anticoagulant like rivaroxaban - my GP practice send reminder every 6 months for these blood tests. In my case most recently liver and kidney function were fine but my blood count was seriously low which would explain the terrible tiredness and occasional dizzy spells I was experiencing. Caused probably by a long slow bleed helped along by the anticoagulant- so I am very thankful for the regular testing which picked this up!

The bleeding has stopped since I stopped taking rivaroxaban and bits of my colon have been zapped with a laser. The big question now is whether to go back to taking rivaroxaban- despite all the recent problems I am really uncomfortable remaining un-anticoagulated and the risk of stroke.

So - for these reasons I really recommend you should ask your GP to arrange regular blood tests.

Liz xx

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O my, you have been through it!

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Yes it has been a worry but ok now. And of course I assumed the fatigue was caused by AF when actually It was due to anaemia- borderline blood transfusion time according to my GP!! When I go back on rivaroxaban I have to have monthly blood tests to make sure it doesn’t happen again. All part of the fun of getting older I think 🎉😀 😂

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I have a blood test every year at my surgery. They never send a reminder, I just ring up and say its due and they book me in.

Cassie

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I began Apixiban last September (with much concern) but have been fine with it.

I have blood tests every three months which seems very different to the experience of others in this forum.

I am not sure whether this is because I have a caring GP or he has other concerns that I am not aware of!

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I have been on Apixaban for 2 months now and at my last GP visit he gave me a prescription for a blood test for liver and kidney function tests to have done before my next visit in 6 months time ( here in France you can't get your prescriptons renewed without seeing the doc at least every six months so they can poke you and prod you and ask a pile of questions ).

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No need for testing on Xarelto. Only those ancient meds, that those that have poor healthcare plans are forced to be on have to be tested. But if you actually fix the problem with an ablation, you can STOP taking whatever kind you are taking.

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It is not so clear cut Aufgeblassen.

I have had 2 ablations and they did not work. For me it was a horrible experience twice. Both times I had to wait hours to go down to theatre and both times the after care was brief but in a HDU for drug addicts or, sadly for recent diabetic amputees. Quite traumatising!

For many other lucky ones ablations work.

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Sorry you got inadequate care. Both mine were spectacular results.

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I am glad.

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I have been told I can never stop the anticoagulant . Other meds, yes, but not the xarelto. Since most of my family has been stroke prone I will keep on with the anticoagulant even after the 3 month ablation recovery period.

No use for anti arrhythmia drugs. I’d rather wait through an incident than feel like I’m trudging through mud and fog on meds.

Hoping the ablation “takes”. It’s a long recovery and the surgery induced anemia and Multaq induced cough are very tiring. Quit the Multaq with doctor approval and am taking iron supplements and eating lots and lots of raisins.

Also quit alcohol after 50 years of beer and wine. Big adjustments!

Trying to get back to four miles even if it’s strolling. Not there yet.

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An aspirin a day should prevent strokes. I'm still on a low dosage anti-arrhythmia med (metropolol), 1 year after ablation, and probably always will be, but stopped Xarelto 4 months after ablation.

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My EP says aspirin won’t do the job and I need to be on anti coagulant. Have been on xarelto 2 years almost with no apparent side effects.

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My cardio is well up as the anticoag specialist for a big area. Previously he had suggested to me (and I took for a short while) Rivaroxaban with no side effects. He said if I restarted anticoags it would be Edoxaban as Rivaroxaban has had some bad Press recently from the States I believe. I find it a tad weird how there are around 4 DOACs and no clear favourite.

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I've been on Rivaroxaban now for about 16 months or since the day I was diagnosed, I am in constant AF and have never had check up on my meds since that day apart from the cardiologist a few weeks later, who left the Rivaroxaban the same but took me off Bisoprolol for obvious reasons and put me on Tildiem.

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