What should I do if I forget my anticoagulant? - AF Association

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What should I do if I forget my anticoagulant?

BobD
BobDVolunteer
38 Replies

This is a common question so i was delighted to come across the following in a new fact sheet from Thrombosis UK which I have been given permission to borrow. It has been approved by medical specialist so take it as gospel.

Apixaban.

Take the table as soon as you remember and take the following tablet at the usual time and then contiune as normal.

Dabigatran,

A forgotten does can be taken up to six hours PRIOR to the next dose due. Do not take double a dose to make up for any missed.

Edoxaban

Take the tablet as soon as you remember. Do not take more than one tablet in a single day to make up for any forgotten dose.Take the next tablet on the following day and then carry on as normal.

Rivaroxaban

If you are taking either 15mg or 20mg once a day and have forgotten a dose take it as soon as you remember. Do not take more than one tablet in a single day. Take the next tablet on the following day at your usual time and then carry on a normal.

So now you know!

Bob

38 Replies
oldestnewest
Ianp66

Good sticky Bob 👍

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Finvola

Very useful - can it be pinned please?

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BobD
BobDVolunteer
in reply to Finvola

Will email Rachel.

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BobD
BobDVolunteer
in reply to Finvola

Now pinned post !

5 likes
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meadfoot

Thanks Bob.

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Susangibbons

Very helpful Thank you for sharing 👍

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Glenn50

Great. Appreciate the answer.

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Eddie49

Hi, with regards to Apixaban, does this mean that it can be taken within 3-4 hours of the next dose for instance or should it be left off that close?

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BobD
BobDVolunteer
in reply to Eddie49

I just reported what was in the fact sheet so can't answer that questsion. If one is that forgetful maybe find a better way to remind one to take them at the proper time.

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Eddie49
Eddie49
in reply to BobD

Sorry Bob, I have only just been put on Apixaban. I thought I had read somewhere that there is a six hour limit to the next dose even with Apixaban. Obviously, taking it on time is the way forward.

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CDreamer
CDreamer
in reply to Eddie49

If I forget a dose I usually only remember when I go to take my next one! I certainly don’t take them within 6 hours.

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CDreamer
CDreamer
in reply to Eddie49

Exactly my thought.

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Tapanac

Thank you Bob. So useful as I forgot or couldn't remember if I had taken my Apixaban, took another and then thought I had doubled up (old age). I dialled 111 and they just said go to A & E. I didn't because I had so much help on this site. Thank you again for making things absolutely clear.

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Buffafly
Buffafly
in reply to Tapanac

I think I took an extra Apixaban a couple of days ago but it was too late by the time I realised and I'm still here. The Apixaban foil strip I have has 7 each side so I can easily see which day I am on but I have been distracted this week and concentration has gone to pot.

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BobD
BobDVolunteer
in reply to Buffafly

Know the feeling!

2 likes
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GrannyE
GrannyE
in reply to Buffafly

I know the feeling too.

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lallym

I am on apixaban. If I forget one I take one as soon as I remember and then work my way back to my normal time in hourly increments. So only ever have 11 hour intervals.

Ie. Should take it at 10am. Forgot until 1pm. Take tablet, take the next one at midnight, next one at 11am, next one 10pm and back to normal.

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BobD
BobDVolunteer
in reply to lallym

From the above you will see that not really necessary.

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lallym
lallym
in reply to BobD

Yes probably right but you know...safe/sorry!!

1 like
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goldey

I think most people have a phone or a watch with an alarm on it -- or even the timer on your stove or something --- just set your device to go off at the same time every day as a reminder. Better to not have to even think about it -- just make it a normal part of your daily routine.

3 likes
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lallym
lallym
in reply to goldey

Do set timer and then get sidetracked!!

2 likes
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Buffafly
Buffafly
in reply to lallym

Me too!

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Aufgeblassen

If you do NOT have AF, and are merely taking it as a precaution, and can monitor with a BP cuff that reports AF, or have other means of checking for AF, that is all you need to do; check a couple times of day.

Should you check and find or feel AF (and then immediately check), got to ER immediately, to get problem FIXED. Even if you were on anti-coagulant, the routine is NO different; got to ER and get problem FIXED.

More than once prior to surgery I had to STOP taking mine fore a week (whilst NOT in AF) - no big deal. Should I have gone into AF, I would have immediately started taking my leftover Xarelto, and gone to ER to get it FIXED, and cancelled/rescheduled my surgery.

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BobD
BobDVolunteer
in reply to Aufgeblassen

For the record this advice is nothing to do with being in AF or not as it is medical advice from a different scource as stated. The amount of AF or even being in AF has no relevance here and as we know just having a diagnosis of AF brings on the risks which largely and for most people are not removed by any alledged "cure".

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Aufgeblassen
Aufgeblassen
in reply to BobD

The "alleged cure" (ablation) has a 65% chance of AF NEVER, ever returning after 1st ablation, and 85% after 2nd one. The other stuff you said is non-sense, and what I stated is absolutely correct. I detail both possible situations; forgetting to bring your med whilst taking precautionary anti-coagulants whilst NOT in AF, and what to do TO BE SAFE should experience an sudden AF episode.

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Aufgeblassen
Aufgeblassen
in reply to BobD

For the record: You have a "diagnosis of AF" when you are experiencing AF, and don't when you don't. No such thing as having a diagnosis of AF, if you are not experience it (i.e. it is NOT detected).

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BobD
BobDVolunteer
in reply to Aufgeblassen

Best we agree to differ .

3 likes
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Aufgeblassen
Aufgeblassen
in reply to BobD

Can you please specify in a nutshell HOW we disagree?

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GrannyE
GrannyE
in reply to BobD

Am I right in thinking that after an ablation the blood vessels can be in fibrillation but the scar tissue stops the electrical impulses coming through to the atrium of the heart? The body can heal over the scar tissue and the A/Fib comes back to the heart itself

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BobD
BobDVolunteer
in reply to GrannyE

That is a very simple explaination but in principle yes that is correct GrannyE. The scar tissue stops the rogue impulses from getting from one area to another but doesn't stop the base cause. All and any treatment is only for quality of life and suspension of symptoms. There is little really long term data but five years AF free has always been a target. Mine is now eleven years but other arrhythmias (not AF) arrived long before that.

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Tux18

What about Xarelto - if you forget to take it? I didn't see it listed.

1 like
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BobD
BobDVolunteer
in reply to Tux18

Rivaroxaban! Xarelto is a trade name. I did not include any trade names only that of the drugs.

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Tux18
Tux18
in reply to BobD

oh, I didn’t know.

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BobD
BobDVolunteer
in reply to Tux18

Maybe I should go back and add trade names? If I can remember them lol 😁

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AFHenz

Thanks for sharing and interesting to note .... Probably a strange question, but why wouldn't Warfarin be included?

1 like
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BobD
BobDVolunteer
in reply to AFHenz

Valid question not strange.To be honest I'm guessing because Warfarin has such a wide window. If you don't take a dose for a whole day your INR would not suddenly drop to 1. From my experience it takes four or five days to do this. Similarly if you double dose nothing bad will happen. When I started my warfarin 15 years ago the system was to take 10mg for three days and then test and adjust accordingly . Now they try to creep up on target which can be frustrating as it often takes many weeks to find the right doseage. Remember that "our " target of 2.5 (i.e. between 2 and 3) is quite low compared to that for some conditions and up to 5 is not deemed dangerous by experts. I think that so long as your mg s over a few days average out it's all gravy as my boys would say.

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AFHenz

Thanks for your observations on this Bob .... Makes my INR reading of 2.9 yesterday feel quite comfortable.

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ijan

Thanks Bob, very helpful as I was wondering what to do having been three hours late taking my Rivaroxaban today. First time I ever missed a dose, don't know where my head was.

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