Following the removal of a brain tumour in 2018 I spent 7 weeks in ICU during which time I had atrial fibrillation. I had injections daily in hospital but on discharge was told to go to my GP for anticoagulants in tablet form, which I did and was started on riveroxibane, this caused severe nosebleeds on a daily basis for about a year, despite constant visits to GP when I was started on water tablets for high blood pressure. I returned to Dr for yearly review and was asked if I bruised easily or had nosebleeds, I confirmed that I kept getting nosebleeds and had reported them was started on Apixoban which made me feel very ill after about 3 days, again I was changed to edoxoban but told if this didn’t work I would have to go on warfarin, I didn’t want to as I knew there were multiple restrictions ie diet and checks, when I asked what the side effects were I was told the same, nosebleeds. I asked for a lower dose edoxoban but was told there wasn’t a lower dose so since lockdown I have been shaving a little off these tablets and the nosebleeds have almost stopped which is a massive bonus. Do you think this is wise or should I try warfarin after lockdown
Walfarin versus other anti coagulants - Atrial Fibrillati...
Walfarin versus other anti coagulants
Two important things about Warfarin - 1 ... you need to ensure your GP operates an INR Clinic at or near to your surgery and that if you choose this pathway you will be supported.
2 ... why be supported ....Well, I would recommend that you self test by buying a device from the manufacturer, Roche, for their Coaguchek XS device. This will ensure you do not have to continually visit the clinic for testing. It is important for you to be supported because you have a good chance of getting test strips on NHS prescription . It is also important to have this support during the early stages of using the testing device.
The advantage of self testing is that you can do it anytime, anywhere- you are not locked into weekly fortnightly clinic visits. I have even taken mine on holiday to Australia.
Conceptually, it about the same as a diabetic does when taking a blood test. You get a Lancet, load it into a pen, then puncture a finger drip blood onto a test strip and bingo ...you get a reading.
You should be advised as to your therapeutic range and a mid point value, the theraputic value, you'll be taught about diet, what to eat and what not to eat. Although the big secret here is what you eat you do so with consistency.
For me, I take a blood test, phone the result to my clinic (at my GP's surgery) , they process it via software , they ring me back tell me the next dose and the next test date.
I can't tell you to try it or not, because it has risks and challenges, as any medication has. All I've done is give you a very broadbrush overview of tasks involved.
Hope it helps, good luck.
John
The important thing about warfarin is to make sure that you eat a balnced diet. Don't avoid anything. In time your INR and warfarin does will balance out. People have problems when tehy try to make their diet fit the warfarin.
Reducing the dose of whatever you are on may leave you exposed to stroke so not a great idea.
I had worse bleeds and bruising on warfarin than now on Rivaroxiban.
All different
I've taken Warfarin for many years and have never had any side effects from it. I've had nose bleeds since childhood, still get spates of them but they're no worse and perhaps a little less than before.
I’d never had them until I started riveroxoban then my bathroom was like a bloodbath each morning. I’d also had my thyroid removed and when I went for ENT appointment last year he put something up my nose to see if it needed cauterising but it didn’t so must have been blood thinners causing it
Ah right! When I had my throat checked one time because when I was giving talks I was losing my voice, the consultant looked via my nose and could see the spot and offered to cauterise it but I said no, thinking that if a blood vessel was going to burst anywhere I'd rather it was in my nose than elsewhere in my body. I get mine more in the summer and usually after getting out of bed or washing my face, they don't last for long.
Yours certainly sound like the pills are the cause. I wouldn't worry about trying Warfarin if the need arises. I find that I don't bleed any more than I've always done since starting it.
I think you can get Edoxoban in 30mg & 60mg
tablets.
Oh it’s a pity you couldn’t tolerate apixaban as I was on rivaroxaban and that didn’t work well for me with blood in urine. However, touch wood, the apixaban is fine and I was told by my consultant that it is the kindest tablet there is especially to the brain and the stomach.
I was especially pleased about the brain as I too had a brain tumour surgery in 2016 and still have checkups.
Good luck.
Another thing are you sure it was the tablets that caused the nosebleeds as a friend of mine has them almost constantly and they are caused through a leaky "vein’ which has been cauterised and she doesn’t get them nearly so often. My mum used to get them as well because of polyps. They were removed and she was fine.
I've been on Warfarin for several years and have never had any problems, but we're all different.
What I would say is that it's silly to mess around with your anticoags because having a nosebleed is nothing compared to having a stroke....stay safe.
I know but it has been nice to be pretty much nosebleed free for a couple of weeks especially as they came on no matter where I was, was hugely embarrassing if I was holding a tissue to my nose in one hand with blood dripping through whilst I was searching my pockets with the other hand for another tissue. Still you’re probably right. I’m on them to stop strokes after all
Maybe you should give warfarin a try as it is carefully controlled to keep you within a specific range.
It might be a good idea to have your nosebleeds investigate, you could have some problems with veins in your nose which can be fixed with cauterization.
Good luck
Thanks. I am under ENT following a major op to remove my thyroid and told him at last year’s review about the nosebleeds and my referral to my local hospital to explore cauterisation had been cancelled until further notice. He put some sort of probe up my nose and said he couldn’t see any need to cauterise. I have another appointment in July if it doesn’t get cancelled so will check with him again.x
So it might not be the apixaban after all. The good thing with this one is that although it’s twice a day there are no problems in that you have to take with food and no restrictions. I take mine at 8.30 am and 8.30pm. By the way as everyone will tell you the biggest danger is the threat of strokes. A friend of ours has PAF which is sometimes troublesome and was told to take anti-coagulants, but he wouldn’t as another friend was on warfarin and kept getting nose bleeds. So what happened our friend had a stroke last Sunday - he is now on apixaban!!!!
Maybe not but I felt quite ill after taking it for about a week. I rang the surgery and told them, she spoke to the doctor and told me to go back to the rivroxoban which started the nosebleeds again. Nightmare x
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