The clinical pharmacist at my GP practice gave me a choice between Rivaroxaban or Apixaban. I chose Rivaroxaban simply because you only have to take it once a day and I can take it with my other tablets at breakfast. I should add I have acid reflux which is well controlled if I don't eat anything silly, particularly in the evening.
Given your experience do you think I made the right choice? (Sorry this sounds like an exam question). I've been on Rivaroxaban for 4 days and so far so good.
Exactly the reason I chose Rivaroxiban , not unhappy with my choice
I was put on Edoxiban due to having other medical conditions and it seems to suit me. They kept me on it whilst I was in hospital for two months, seriously ill with it on HDU. I was due to have an ablation in the same week as I got Covid so postponed now so not had another appointment yet
I’m on Rivaroxiban - no dramas. I had two separate short stints on Apixaban and was very unwell. Can’t say for certain it was a reaction to the drug - most people seem to be okay with it. I also had a try on Pradaxa but as I have a sliding hiatus hernia and reflux that was no good for me.
Good choice BUT Rivaroxaban MUST be taken with a proper meal preferably including some fat or it is not absorbed correctly and you may not be fully protected. There was an emergency bulletin about this last year after some people on it had strokes taking with just a drink and a biscuit for breakfast.
I have been taking Rivaoxaban for years, no issues. Must be taken with a meal, not just a biscuit though to enable it to be fully active and be taken at the same time each day. I have acid reflux but had it years before rivaoxaban so cant blame that.
I was told by the clinical nurse to take riveroxaban with a biscuit as I’m never hungry for breakfast in morning I was taking it on it’s own I now take with two biscuits cereals don’t appeal what else could be taken
Thanks all. Very reassuring. I do have a proper breakfast but I'll have to review whether I'm getting enough fat. I would normally avoid fat. Would semi-skimmed milk be enough I wonder.
Depends what you mean by ‘proper’?
Protein + fat is required in order to digest the tablet so fruit with yogurt + eggs - perfect or take with evening meal. Just avoid cereals & baked goods only so cereal with skimmed milk would be pushing it. Advised = 500+ calories.
Friend of mine had problems with heightened liver enzymes after 3 months - they were taking with inadequate breakfast - changed to taking with evening meal & soon went back to normal.
What about with a couple of slices of toast with butter ? Worried a bit now as that is what I take mine with each morning
Depends upon the bread and the protein content. A good organic seeded whole meal would be fine but supermarket bought white processed - don’t think so but add an egg and that would suffice.
I hate eggs and wouldnt have time to do an egg...always use brown wholemeal bread so hopefully not an issue - thanks for the advice
What I learned only recently (from a rather weird source, but believable) is that protein on it's own will not be absorbed properly without some fat content present. Good to know.
The source concerned starving people turning to cannibalism to survive, but the dead people they were eating did not carry enough fat. 
I prefer & chose Apixaban - kinder on the body, especially liver & no need to take with food. I need to take other meds every 12 hours anyway so twice a day is not an issue.
I like Apixaban as if I forget a tablet I am not in difficulties for so long!
Difficult to say. My impression is that as long as you are able to follow the instructions exactly, it’s more a case of sticking with one unless you have problems. It sounds like the pharmacist thought the same, unless there was a reason not to choose the others (other than cost)?
I’m very happy on APIXABAN having done some research beforehand. The reason I chose it is that I tend not to eat until midday and didn’t want to be tied to eating at the same time always. It seems that APIXABAN is kinder to the organs. Also I suffer from nosebleeds and I wanted a twice a day NOAC so that I had more control. I’ve been as fit as a flea on it and do not regret my choice. But we are all different.
My Cardiologist told me that, by far, his favorite anticoag is Apixaban. So, that's what I've been on for about 6 months now. Although, I hope to be off of it ..... well before end of year. No issues with it yet.
I chose apixoban for two reasons. The first, life is complicated enough without needing to be sure your meal and meds are properly matched, a tablet twice a day ( getting up, going to bed) is not a problem for me.
The second is much more superstitious, my dad was on riveroxyban in his mid 80s and had an unpleasant and scary bleed from his bowel. So I mentally associate it with worry. To be clear I’m sure any anticoagulant would have been the same for dad but as I said it was a factor
With apixoban I was and am so side effect free I made a worried call to my doctor along the lines of “ does this stuff work for everyone?” I really can’t tell I take it
Steve
I've been on it for a couple of years with no issues
I have had both Apixaban and Rivaroxaban. Apixaban caused nausea after being on it for a few weeks, though I had the same problem with Dabigatran and Edoxaban. I was on Rivaroxaban for longer but that caused erosive gastritis with some bleeding and a gastric ulcer.My choice without the nausea would definitely be Apixaban. Taking it twice a day means that if, for example you are having a tooth out, you can just leave the morning dose until after the procedure.
My cardio changed my warfarin to riveroxaban as I was having ectopic beats because my pulse was too slow at 45bpm so he also halved my bisoprolol now on 2.5 per day but had very bad muscle spazms after 3 weeks so I told my warfarin guy about it so went back to warfarin n.i am a 78 year old working plumber. Good luck
Thanks all, very interesting. The clinical pharmacist didn't mention anything about the kinds of foods you need to take with Rivaroxiban. I have three breakfasts - poached egg on wholemeal toast, porridge and wheatabix, both with semi skimmed milk. From what you say the egg breakfast would be OK but the other two might be pushing it a bit. I'll discuss again with the pharmacist when she calls. I've got a blood test scheduled for next Friday.
Yes I am not sure it says on the advice sheet that you have to eat so well. It just says take with food, surely if there had been an issue they would have adapted the advice sheet?I boil eggs eight at a time and leave them in the fridge unpeeled, makes it far easier to grab one with a slice of bread for breakfast, as I would before medication not eat until lunchtime.
Please read the link I posted the other day regarding various anticoagulants and stomach issues.
When I was taken off Warfarin last year at the start of the pandemic, I was put on Rivaroxaban and immediately began to have bleeding problems especially into the bladder - pink or red, sometimes deep red, urine every 2-3 days. GP changed it to Apixaban and problems have become insignificant - slight pinkness only, probably once every 3-4 weeks or more. I am still under the urology people however, and at the latest checkup 2 days ago, I mentioned how much better it seemed: the consultant replied that all NOACs give more trouble in that department than Warfarin; as long as the bleeding stayed as mild and infrequent as it now is, there should be no real problem about staying on Apixaban, but if the GP ever wanted to increase my dosage I should ask, instead, to go back to Warfarin. So for me, Apixaban OK, Rivaroxaban absolute NO-NO. Good luck!
I've heard that as well from a nurse friend that NOACs cause more trouble than Warfarin. I was told by the pharmacist "we don't prescribe Warfarin any more".
I've been on Rivaroxaban now for almost a year - I suffer from paroxysmal AFib.I take it with food-evening meal.
I thankfully have not had any side effects whatsoever apart from bleeding a bit more freely when I cut myself.
As far as I'm concerned it's a great drug.
Same here, I take mine with my evening meal also. I have been on it for a year, and no problems so far either.
Years ago I took part in the original trials to compare Apixaban with Aspirin and have been on Apixaban since the trials ended, some 15+ years ago! Never had a problem in any shape or form; now aged 66 and going strong. Apixaban is also being looked at by various organisations in Cambridge (UK) to see how it can help prevent further complications in patients that have come out of hospital after having had Covid-19, so can't be all bad.
I have been on Rivaroxaban for a few years now. Used to take it in the morning but GP told me I should be taking it in the evening instead with a 500+Calorie controlled meal for it to work properly. So far no problems except occasional nose bleeds also a bit of gastric acid but take tablets for that.
What is a 500+Calorie controlled meal?
Thank you
A substantial meal which consists of more than 500 calories or a meal with some fat in it! That's why it's recommended to take after your main meal!
That makes sense Bowcat. But I have my main meal at lunchtime whereas I take my other meds at breakfast. So I would lose the convenience of taking everything at the same time once a day.
I have been on Rivaroxaban for over 5 years now with no side effects. I take it after my breakfast along with my other tablets. My breakfast is always porridge , seeds, and fruit. My porridge is made with organic semi - skimmed milk. I like all my tablets to be in the morning if possible as l am ,more likely to forget them later in the day.
I've been on Warfarin for 15 years. I turned down the opportunity to have rivaroxaban following the death of a friend who was taking it. She broke her hip and bled to death because there was no antidote to the anti coagulant. Had she been on Warfarin an injection of vitamin K would have stopped the bleeding.
I was on rivaroxaban, but I kept getting blood in urine so was changed to apixaban. Fine. I was told that apixaban is the kindest anticoagulant especially to the brain and stomach and as I had had surgery for a brain tumour I felt reassured by this. Good luck
I wasn't presented with a choice. They moved me from Pradaxa to Xarelto and I couldn't be happier. Xarelto has been very very good to me.
Yes
I took Rivaroxaban for 12, days, only Suffered excruciating pains. Taken off them by GPs. Once bitten, twice shy, so I went back to Warfarin which has been used medically for over 70 years.
I cloose APIXABAN as I had problems with Riveroxaban resolved by Apixaban. Also Apixaban has the lowest side effects of any other Anticoagulant when I researched it..regards
Hugo40
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