Apixaban and other DOAC'S - liver function tests

[Finvola]

I thought I'd post this to remind others that liver and kidney function tests - either every six months or annually, depending on the local protocols, are recommended for patients taking new oral anticoagulants (DOAC's).

My liver enzyme alkaline phosphatase (alk phos) level has been slightly raised since I started Apixaban nearly six years ago. Levels are not alarming at around 146 - 170 (normal levels are between 30 and 130) but my GP says it is important to keep it under review and ensure that the level remains stable. Blood tests every two weeks at the moment and I have been given calcium/Vit D tablets as well.

I'm most impressed with our wonderful NHS. Hope this is of interest to members taking Apixaban, Dabigatran, Edoxaban or Rivaroxaban.

[BobD Volunteer]

Thanks for that Finvola. Always good to have this emphasised. Many GPs do not seem to know this.

[10gingercats]

Yes. from correspondence on this site it seems not everyone is getting regular liver function checks.Calcium and vit D should be prescribed for all women approaching the menapause but this rarely happens. It would save the nhs oodles of money if prescribed then as fewer people would go on to develop osteoporosisand/or be at risk of broken bones. I was prescribed at 50 but not by my GP.I was on a trial at a local hospital that checked bone calcium levels in menapausal women ...... and only now at 81 have low level osteopenia .....of course diet and exercise also count

[Bagrat]

No it was unknown at our practice till I pointed it out. My Alk phos is reviewed too but every 3 months as it is like yours a bit above normal about like yours but no treatment!!

[Eirecara]

I haven’t been informed about this. I have multiple cysts in my liver and haemochromatosis (genetic) so I think I will ask for a blood test. Thank you. Best wishes ☘️

[wilsond]

Thank you Finvola. Yes indeed long live the NHS!

[heartmatters1]

My husband & I have both recently received letters from our GP practice to make an appointment to have blood tests (if they haven’t already had one routinely) They have sent them to everyone in the practice, who are on anticoagulants, so they can update their records, following NICE guidelines for DOAC’s.

[opal11uk]

Thank you, I have been on Pradaxa for over a year and no tests so I will ring the surgery next week to make an appointment x

[cat55]

Thanks for the reminder, I've just checked and it's nearly 18 months since my last blood test. It's strange really, my husband gets reminders for blood tests and flu jabs as he has chronic kidney disease, I have AF and I take thyroxine but I always have to go and ask for relevant blood tests. This time I have forgotten. I think I am going to have to be more organised, thanks for the timely reminder. Best wishes Kath

[mariah222]

Thanks Finvola, I was just catching up with this greatly informative site as I have some middle back pain setting in and wondering about my liver.

Have been on Apixaban for a couple of years now and may be due for another blood test.

I didn't know what normal levels were till your post, very helpful.

[brit1]

wow so its liver as well as kidneys that could be affected by these DOACs

[Finvola in reply to brit1]

I’m not sure that Apixaban has caused the rise in this enzyme or if it has some internal (to me) source. It seems to have dropped slightly since I started calcium tabs but I’m assured by a cardiologist that it is nothing to be alarmed about.

I think the testing of liver and kidneys is done to make sure that the anticoagulant is being processed by the liver correctly and excreted normally by the kidneys.