Some advice sought about AC drugs

[AstroFish]

Hello. AFA suggested I join this forum as, probably like many people, I have been advised by a consultant cardiologist to take an anticoagulant having scored 2 (I am a female aged 65). I accept that this is a sensible suggestion (despite understandably not being terribly happy about having to take such a string drug for life) BUT my biggest concern is making sure I end up on the correct medication for me and my lifestyle.

The consultant suggested Edoxoban, which I haven't yet started taking. I like the idea of once a day but wonder if I would be better on a two a day drug, like say Apixaban. Is anyone else on Edoxoban and how do you find taking it? I tend not to eat much in the mornings, so it was felt perhaps that once a day would work better for me, if I take it with my main evening meal. I am so worried about this, and making the right commitment as I don't want the wrong drug for me or a massive dose. On top of this, I suffer from terrible nosebleeds, and I didn't really get a satisfactory answer as to whether taking an anti coagulant would mean I don't clot at all, or just clot as slower rate.

Lot's of questions in there, if anyone is able to provide a good overview? The GP is stretched right now, and they tend to book me in with locums, which is no problem in itself, but I don't feel I have a relationship with any medical practitioner in which I can really air all my concerns, which to another person may seem petty.

Hoping for some clarity. Thanks for reading.

[BobD Volunteer]

Firstly anticoagulants don't thin blood or make you stop clotting, they just slow down the clotting process. The modern DOACs as they are known like Rivaroxaban. Apixaban. Edoxaban etc are factorX antagonists working on a different part of the clotting process to warfarin which has been around nearly as long as I have. (Been on it for sixteen years with zero problems)

Edoxaban seem to be the drug of choice in a lot of areas I suspect because of agressive pricing policies. Others may comment on ease of use but please whatever you do follow the guidance carefully .

Anticoagulants are to most of us our best friend and give us good protection from stroke but even so I do see many people who come here for the first time showing concern about taking them. The often missused term "blood thinners" I blame for this as it tends to suggest something dangerous. They are not when correctly used.

That said there is no "best" drug as we are all individuals. I have never had a problem with warfarin which was the only anticoaulant available when I started my AF journey so that is my drug of choice. Rivaroxaban is the usual choice of doctors here in my area but again others may find differently.

Just do as advised but keep vigilant for any odd things which may occur. Keep in touch with your doctors if you are worried.

[Tapanac]

Hello. Please don’t worry about anti-coagulants which just slow down blood clotting (protecting from strokes, etc). They are not blood thinners.

I was put on rivaroxaban to begin with, but I kept getting blood in my urine and uti occasionally. After a year I was transferred to apixaban as I was told this was the kindest ac to gastric, bladder and brain. Touch wood I have been fine since and have been on this for over a year now.

I believe doctors are using edoxaban because it is a cheaper drug.

Please try not to worry and protect yourself after all a stroke or anti-coagulants, no contest in my view.

Best wishes

[Beta44]

I was on Apixaban which subsequently changed to Edoxaban. I had no problems with either although it is easier for me not having to remember to take the evening tablet.

Peter

[momist]

IF I forget to take my tablets, it's always the evening ones. I reliably take my breakfast dose every day without ever forgetting. I'm now waiting for a date for my ablation, after having the pre-op a week ago, and now MUST NOT forget to take the anti-coagulant, or they will re start my waiting time. Once a day would be much easier, if you are not taking any other drugs regularly. Luckily (or not) my three doses are all twice a day, so if I forget one I've forgotten them all.

With the AC, missing a dose will reduce your protection temporarily, but it will soon build up again. The aim is to keep a certain level in the blood.

What BobD didn't say about his warfarin, is that you have to have regular blood tests for something called INR, which you don't need on any of the DOACS. You do however need annual or biannual checks on your renal function.

[djmnet]

Helen, I was also subject to nose bleeds quite often that were sometimes difficult to stop. I was also worried about that when I started taking apixaban about 3 years ago, but oddly enough I have not had a single nose bleed since I started taking it.

[AstroFish in reply to djmnet]

Thank you so much. My Gp today swapped me to Apixoban so I do hope it suits me well. Your comment has reassured me. Thanks