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Medication missed or doubled?

Borderstories1 profile image
26 Replies

Last night I was super busy and went to get a glass of water to take my Apixaban and Bisoprolol at 7pm as usual. I set the water down. Then at 9.30 suddenly realised I hadn’t taken my meds.... or had I? In six months of taking them I’ve never forgotten or been confused but last night I totally couldn’t remember. Blank. So I took them. Then felt panicked over whether or not I’d then doubled up on the Apixaban (which worries me more than the bisoprolol).

This morning I am unsure as to whether to take the Apixaban!!! If I did take it twice last night do I really want a third does 12 hrs later? But if I didn’t then is it ok to potentially miss a dose this morning? Should I leave it until tonight?

I can’t ring my gp to ask because her phone appointments are not until late afternoon.

Sorry I know this is a very dull question I’m just so new to anticoagulants that I don’t want to err.

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Borderstories1
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26 Replies
wilsond profile image
wilsond

I was in the same position several years ago..Advice was if in doubt over double dose,miss next one and take as normal next time. CD had a great idea on here,get a sharpie pen and write am and pm on the Apixaban strips. I have a pill box with 4 sections per day..very useful. Also put on phone alarm for evening dose,which is when I seen to get distracted. Ring surgery if you are still concerned or 111? Xx

speak to a pharmasist, they will be able to answer your questions.

may I suggest a weekly dosset box for your meds, reduces the chances of forgetting/taking too many

BobD profile image
BobDVolunteer

For goodness sake get yourself a seven day pill box . Neither solution offered will hurt you I'm sure but at least that way you won't worry. (provided of course you know what day it is. I spent three days one out and only found out when my dustbin wsn't emptied. )

jeanjeannie50 profile image
jeanjeannie50 in reply to BobD

😂😂🤣 Know that feeling well Bob. I'm usually wheeling the dustbin out and my neighbour kindly tells me, you're a bit early!

Padayn01 profile image
Padayn01 in reply to jeanjeannie50

Any news yet Jean on your Cardioversion?

jeanjeannie50 profile image
jeanjeannie50 in reply to Padayn01

No, I tried to ring them a little earlier but no answer. Think today may be the day they do cardioversions, so all out of the office helping.

Padayn01 profile image
Padayn01 in reply to jeanjeannie50

Oh i do hope you get it soon x

JaneFinn profile image
JaneFinn in reply to jeanjeannie50

I hope it’s soon, Jean Jeannie - fingers crossed- do let us know xxxx

Borderstories1 profile image
Borderstories1 in reply to BobD

😂😅 it’s true some days I have no idea of the day, perhaps a pill box would keep me in order 🤪 my four children keep me well and truly distracted (particularly my 7 year old, who was the cause of my distraction last night...

checkmypulse profile image
checkmypulse

Pill box and alarm the way to go,then the same day every week you organise the next weeks tablets. The medics usually say miss next dose then resume as normal.

You could ring British Heart Foundarion. The cardiac nurses there won’t give specific medical advice, but they would know who you could contact. Possibly 111-they could arrange for a nurse or (more rarely) a doctor to call you back with advice. At any rate you need to get professional advice as this is serious stuff.

JaneFinn profile image
JaneFinn

I sympathise!

I agree that I’m sure you’ll be fine either way, but that it’s good to get advice :)

I asked about this during my EP appt (where I saw a cardiac nurse, not the EP). Her advice to me was that if I’m not sure I’ve taken one, it’s always better to take two Apixaban than to risk missing one. And if I know I’ve taken two at once, I should still take one 12 hours later, as otherwise I won’t be fully anticoagulated. (She said in case I needed a cardioversion or ablation it was important not to have missed a dose, and that taking double at one time doesn’t cover me for the 24 hours, it just double-covers me for 12 hours !)

I realise this is the direct opposite to the advice given to Wilsond! And others too, I’m sure. I wonder if the relative wisdom of over or under anticoagulating may depend on the individual? And what other risk factors/meds they’re taking. Or it probably also just depends who you ask! I’m sure you’ll be fine either way, but if I were you I’d get a medical opinion anyway.

Do let us know what they say :) xx

Borderstories1 profile image
Borderstories1

I rang my surgery and the medical receptionist went to ask a dr for me who said if I wasn’t sure I should miss a dose.

JaneFinn profile image
JaneFinn in reply to Borderstories1

Oh well done. Bet this’ll be the last time this happens! If you’re like me you’ll have pill boxes, plus alarms plus extra safety measures (check my pill box is empty etc)!! Xxx

Deb1838 profile image
Deb1838

I had a moment the other day I have a pill pot but I usually take two 2.5 mg of bisopolol in the morning. However the hospital gave me some 7.5 mg. I took my meds as usual thought oh they have changed the manufacturer of the bisopolol again as sometimes it is round and sometimes it’s elongated but this time it was a cream colour. Next day thought that’s strange these pills are white. When I checked the previous day I had taken 2 x 7.5mg 😱😱

JaneFinn profile image
JaneFinn in reply to Deb1838

😱😱!!! Did you feel ok??

(Scary how easy it is to make a mistake, however careful we think we’re being!)

Deb1838 profile image
Deb1838 in reply to JaneFinn

Yes I was really shocked at myself., as I am usually so organised.

Deb1838 profile image
Deb1838 in reply to JaneFinn

Yes I felt fine. Although I am in fast af so I think that’s why I got away with it

JaneFinn profile image
JaneFinn in reply to Deb1838

Oh yes, that makes sense!

Sorry you’re in fast AF though 😕

May I ask how long for, and how fast? (I’ve just had a similar episode that no amount of bisoprolol brought down and had to be cardioverted.) x

Deb1838 profile image
Deb1838 in reply to JaneFinn

It’s been about 3.5 weeks now. Was 140 but it is now mainly 90 and below strangely I cut down my bisopolol from the 7.5 the hospital said to take to 5 and it has been lower rate. I was normally 48 before this happened. I think I am heading for a cardioversion. They wouldn’t give me any additional medication as that meant I would have to stay in 🙄

JaneFinn profile image
JaneFinn in reply to Deb1838

Oh I’m glad it’s come down below 100 at least- still not nice but at least you know it’s not doing harm. I do hope you self-convert before having to have a cardioversion :)

Most of my life i try to avoid shocks to the system (like icy drinks or being woken with a loud alarm) so that I don’t get startled into AF. When I’m in AF I try all the shocks I can think of, in the hopes I’ll self-convert xx

PS Borderstories, I’m v sorry for hijacking your thread :) x

Deb1838 profile image
Deb1838 in reply to JaneFinn

I thought about hanging around the fire alarms at work today as I know they will be testing between 10 and 12 and it always makes me jump out my skin 😂😂

I am hoping it might self regulate it went back in sinus for about half an hour the other day and I thought I had cracked it but no it started again 🤬

irene75359 profile image
irene75359

You must be distracted with four children! I had real problems with remembering to take medication, even with a pill box. I would go to the cupboard the next day and see the previous day's full compartment. Then I decided to take my medication last thing at night. The pill box is in my bedside drawer on top of my face cream and lip salve (shows you my priorities, I never forget those!) and I haven't forgotten since. Although one morning I woke up and found my pills on the bedcover where I had fallen asleep...

wheezybronch profile image
wheezybronch

A dosette box will go a long way to solve this problem but if in any doubt about if you have not taken your medication as prescribed you need urgent advice, 111 is good but I have found the questions excruciating. If someone can take you to the doctor's surgery and tell them your problem, no need for an appointment, you could also go to your local chemist. My action would be to ring 999 and tell them, they have trained medical personnel that will assess you and give you the perhaps urgent advice you need, they may send an ambulance, or advise that you attend A+E etc. Or set your mind at rest ! Good luck for the future.

Borderstories1 profile image
Borderstories1

Thanks so much, some great advice. I like the idea of labelling the Apixaban strip with am/pm which I’ve done already! I’m in my 30’s and have never had to take any medications until now. I think I’ve only ever seen pill/medication boxes as horrific, a sign of illness, rather than something helpful. I hate thinking of myself as ‘ill’ so I have resisted any trappings of a medicated lifestyle and paraphernalia.... if that makes sense. I suppose it sounds a little silly. I’m trying to adjust still I think. My gp surgery is small and personal, and they always have time for things so I’m lucky. One day I went into af driving and passed by my surgery, pulled in and a dr saw me straight away. They said just to ring if I ever have medication worries again ✔️

One issue - I noticed terrible upper left arm pain yesterday evening when I was in AF for two hours (outside of my upper arm). It vanished as soon as I self converted to sinus. This pain happed before when I was on a flight and in AF. That time I had blood tests and scans afterwards and all was fine. Is this a normal AF symptom?

I had AF only once last month and didn’t have arm pain then. But yesterday did.

irene75359 profile image
irene75359

I would post 'One issue' onwards as a new post, you will probably get more answers.

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