I was put on riveroxaban last July because I was diagnosed with P- Atrial Fibulation. I was on beta blockers but they stopped workimg amd higher doses made me ill so I was put onto Verapramil last Jan/Feb .felt miles better & the bone grinding fatigue that beta blockers gave me went.
I then picked up a Virus - very Covid19 like but no testing available. Recovered two weeks later except for a persistant cough and lingering fatigue. A few weeks later I started bleeding from bowl, mouth and coughing up blood. I was fast tracked under the two week rule twice in one week! Bit scary. Came of the blood thinner and the bleeding all stopped.
Waiting to be seen by Cardiology but they've lost the referral so had to be re-referred. The other blood thinners including warfarin are contrary indicated with Verapamil GP said.
Has anyone else experienced problems like this on blood thinners. Maybe my blood is thin enough without a blood thinner?
Be grateful for any advice. Many thanks.
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Hi - personally I haven’t had any problems as you describe. Anti-coagulants do not thin the blood, viscosity is not affected. They do slow down the coagulation affect so blood doesn’t clot as quickly, which is what is so important for us AFers. So glad you were fast tracked and received prompt attention. Internal bleeding is always a risk for anyone on anticoagulants, the good news is that it is rare and not often serious.
I think this is a difficult one, especially if you suspect you have had the virus as there is still so many unknowns about the affect this virus may have.
I think this is one for expert opinion with a good risk assessment for your individual circumstances. What sort of follow up has been arranged and what does your GP recommend?
Beta Blockers were drug from hell as far as I was concerned and can have horrible affects on many people but it will help control fast heart rate and reduce BP. Verapamil is also a heart rate and BP reducer and will not prevent or stop AF but will control the heart rate.
The questions I would be asking is - What are my risk factors for stroke? (CHaDS score). That I think would help you decide. A CHADS score of 1-2 is ‘advisable’, anything over 2 is considered essential. Knowing your CHADS score you would then need to consider what is going to be most beneficial and important to me going forward? Rate control (if you suffer very high HR ie +150 regularly I think that would be advisable (not medically trained though). If you CHADS score was above 2 then I would consider the risk of stroke high and therefore in my opinion, think that was the higher risk and focus on some sort prophylactic treatmen.
For people who cannot tolerate anti coagulants and who are considered high risk there maybe an alternative to anticoagulants - Watchman Device which seals off the Atrial appendage which is where clots that AF tend to cause form which may lessen your risk.
Anti-coagulants are a prophylactic treatment to prevent clots forming in the heart, travelling to the brain and causing strokes, which in AFers tend to be very serious, as I am sure you are aware so it may be about treating the largest threat.
I am sure it is a worrying time for you, not easy to navigate through this type of dilemma
so I think you need more information, more consideration and know more about your risk factors and then more expert consultation before you make a decision.
Hope that helps you to think it through. Best wishes CD.
Thankyou so mich for your thoughtful informative reply. My GP said my risk score was low at 2. My heart runs fast and even on 80mg of Verapamil 3xs daily it is routinely in the high 80s much higher than it used to be before all the bc treatment. The fast heart rate came several years before the A fib.
Am sorry Im not very scientific so I wrote inaccurately. The piece of research I found stated that Verapamil increases how long Riveroxaban stays in the system -the effect fo this is to cause much greater bleeding. The solution was to lower the dose of riveroxaban.
I know this effect has generally been associated with mild or low kidney functioning but more recent research has connected it also with normal kidney function.
I can see why this is more specialist and not for my GP to decide. She was worried lowering the dose would mean it has no effect. Unfortunately and understandably the pandemic mean that cardiology are naturally tied up dealing with COVID19. The good news is I have been referred to the Arrhythmia Clinic so hopefully I will get an appointment in the next few months.
When I stopped taking Riveroxaban the bleeding stopped within 24hrs. I was surprised at how fast that happened. And also relieved! The fast tracking was for suspected reoccurrance of cancer which am glad to say was not the case & that was checked out extremely promptly.
Just a thought - Riveroxaban is a 1xdaily and needs to be taken with food, what and when you take and eat your meal may impact how it is digested and broken down in the body - it’s designed to give you cover for 24 hours, however, other anti coagulants have a 12 hour half life so it may be researching whether the same affect has been reported with those. May be worth considering switching?
I know a friend of mine whose liver enzymes went awry with Riveroxaban as she took hers with breakfast, she changed to taking with a main meal in the evening and was all clear at her next check.
Thankyou CDreamer it would be great if that all I had to do I wish...lol. I took Riveroxaban once per day with my evening meal.
Am glad your friend got sorted though....phew!
I was ok on Riveroxaban until Verapramil was added in.....the problem started a few weeks after that. My doctor in consultation with their pharmacist has told me that other blood thinners are contraindicated to take with Verapamil as the combination causes bleeding.....lol.
Yes I agree I either change Verapramil when advised by cardiologist so can take a blood thiner or look at Abalation to treat Afib and hopefully end up on a blood thinner only.
On my last cardiologist visit he said poor data from the USA on Rivoraxaban and now recommends Edoxaban. The thing is with these new anti-coags is they are still developing a track record.
Thanks Secondtry -love the name by the way!! Ive been told there is no other blood thinner compatible with Verapamil. That all the others have a worse track record of increased bleeding. It has left me wondering if I actually need it!
Who said that? I had mild bleeding on rivaroxaban but no problem with apixaban. Maybe Verapamil could be changed instead? Nebivolol gets good reviews here, best person for medical info is a pharmacist.
I didn’t realise verapamil was a calcium channel blocker until I looked it up. I take Diltiazem and that is ok but I assume there is a good reason why you are on verapamil instead.
So you are on a calcium channel blocker too. I don't know why Verapramil was picked specifically as opposed to others so am afraid I cant answer your query. I was put onto Verapamil by a cardiologist after the beta blockers failed and made me exceedingly ill. Unfortunately they then discharged me and my GP does not have the specialist skills to review my medication hence the referral back to cardiology. Am completely out of my depth with this to be honest.
Oh dear. I've been prescribed Verapamil by cardiologist because I think Bisoprolol is making me ill, so tired, no stamina, poor mood, painful legs and feet, exercise intolerance. I too have thyroid problems to take into account and none of the doctors I've seen care about that.
I've been reading your posts and from them learned that Bisoprolol may have been part of my T4 to T3 conversion problem and now I see Verapamil might be an issue with the Apixaban anticoagulant. This is just not fair.
How are you doing now? What have you ended up with?
Hi Fancypants. Well they've found two underlying conditions for two of the bleed sources......the other my gums cant get near a dentist to check that one out! Still not back on a blood thinner but am doing well. The Verapramil works a treat and I dont have that bone grinding tiredness that beta blockers gave me. You may not get bleeding like me. I think plenty do well on Riveroxaban....
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