Alcohol and Edoxoban

[wordzo]

Hi Everyone,

Person here with AF awaiting a cardioversion and being put on Edoxaban in the next couple of weeks once my appointment with the GP is due. I understand alcohol is usually a trigger for AF so am best avoiding anyway. Just confused however. The consultant told me you can only have one or two pints on Edoxoban, but the NHS website says 14 units per week. I’m guessing that number is spread out amongst the 7 days and not in one night haha. I know it might sound daft. I’m not a big drinker but is a big change as I do like a good drink now and again and just trying to get all the information. I believe it’s the toxicity of the anticoagulant and alcohol on your liver that is the problem when mixed? Is that right?

Thanks

David

[CDreamer]

My understanding is that there are no hard and fast rules but know that alcohol will enhance the anticoagulant affect so not good to take with alcohol and watch how much at any one time so yes, 14 units in one go with anticoagulant will increase your bleed risk.

It’s all about risk management as no-one can say for sure other than the risks will increase with the amount of alcohol you take.

I’m on Apixaban and I enjoy the odd glass of white wine, beer etc but stay well away from spirits so maybe I drink 1-2 units/week maximum. Alcohol can be an AF trigger for some whilst others drink in moderation with no ill effects - it affects us all very differently and will depend on many factors how you metabolise both and the health of your kidneys. You should have a base line blood test for liver/kidney before starting anticoagulants and then regular monitoring which for most is every 6-12 months.

Binge drinking is a known factor for AF so moderation is the key whilst some prefer abstinence.

Hope that helps.

[Steve112 in reply to CDreamer]

It would be interesting to find out from forum members how many are given the recommended 6-12 month Liver/kidney function test you mention..my own experience is I have been on Edoxoban Bisoprolol and Losartan for more than 5 years with No GP follow up whatsoever and to be frank an appalling level of care from my hospital cardiology department but that’s for another thread.... I also avoid all alcohol.

[CDreamer in reply to Steve112]

You are correct. It is appalling as it should be an automatic process, certainly is in our surgery - I get a text reminder, book to see the nurse, a GP - not always mine - screens all the tests returns for that day and surgery only contacts patients if something is amiss but we can access all tests and download from NHS App or online. The GP only get involved when tests need follow up.

You are right, it would be interesting to know how many people DO get monitored and to raise awareness - that’s why I mention it because sometimes we need to push to improve services and as it’s our health at stake, it is important to be aware.

[CDreamer in reply to Steve112]

Surely it’s GP responsibility, not secondary care? I don’t get any follow up from secondary care.

[wordzo in reply to Steve112]

That is not good at all. I’ve always been very fortunate with the NHS and so have my family. But over the years I’ve learnt that you’ve got to practically be a PA for them otherwise things don’t happen or they drag there feet with things. Good luck! I don’t know how stretched your part of the country is. But sometimes worth looking for alternative GP surgeries.

[Hidden in reply to Steve112]

Steve,

I have been on Warfarin for 11 years and have no desire to change. I self test for my INR with an agreed support system ( with my surgery) in place in respect of monitoring my INR. I have had annual Liver/kidney blood tests and follow ups every year without fail, regardless of the surgeries I have been with in that time. Got my next on 20th September.

John

[wordzo]

Cheers. I just feel pissed off with it to be honest. That it now seems the only good thing would be for me to stop it completely apart from the odd glass of wine with a meal or beer. I love going out and I know it may seem like first world problems. My consultant said that it should only be temporarily pre and post cardioversion if it’s successful. But from what I’m reading AF is for life and not just something that is cured from such procedures. I just want them to be straight with me. I was told my life would be normal when the mitral valve repair was successful as a teenager. Was never warned about such problems arising and with the valve still leaking slightly it’s annoying to not know if this is what’s caused it or I’m just unfortunate to of developed AF as well. I am so fortunate to live in the country I do and have access to such healthcare. But still just annoyed. I’m in AF practically all the time and only got picked up recently when I underwent obs for something else. Throughout the years I’ve been in to the doctors with chest pains and palpitations and told everything okay. Never this has been mentioned to me as a possible cause.

[Becksagogo in reply to wordzo]

Wordzo I feel your pain. I wasn't a big drinker and really only enjoyed the occasional glass of lager or a small glass of wine. I have found some really good non alcoholic drinks which have all the taste, don't affect my heart and best of all, no hangover! San Miguel , Becks and Peroni all do zero alcohol alternatives as does Gordon's Gin and a lot of wine producers make pretty good alternatives too. Have fun trying them out!

[cam5961]

Hi, I've been on Edoxiban for 2 years now. I myself am not a big drinker unless on special occasions and I've had no issues with the alcohol and haven't been given any recommendations by doctors or consultants. But maybe affects everyone differently.🙂

[dedeottie]

When I have my annual medication medical review, the doctor/pharmacist always asks me to make sure I drink only up to 8 units a week. I guess because the anticoagulant effects of alcohol combine with the apixaban I am on. It doesn’t affect me as I don’t really drink anymore unless I am out for a meal and then only one, but I must say that it does seem a very miserly amount . I will be interested to hear what you have all been told. X

[wordzo in reply to dedeottie]

Yes that’s it everyone’s situation is different. It does sound a miserable amount, especially being a lover of gin ha. Obviously spirits are now a complete no no. But even so I’m not going to push the boundaries of what is allowed or get close. I understand it’s best to just knock it on the head for good and that’s what I will do apart from the odd wine with a meal. I know it may sound quite sad as it’s only alcohol and I certainly don’t rely on it to have a good time. I’ve been lucky that I’ve been able to enjoy a drink until now. As when I had my valve repair 20 years ago as a 13 year old, they did go in to the operation expecting it to be a replacement which would of resulted in me staying on the warfarin post op for good. But as they repaired it, it was only temporarily and have been able to enjoy life normally without meds until now. Like I say It’s not the end of the world. Just annoying at the moment as it’s fresh and social events I’m use to going to will be different. It’s beneficial to my health so it’s not exactly a negative. Just need to adapt to a new lifestyle and get my head around it. Like you said it’s interesting to hear other people’s decisions and advice they’ve been given.

[dedeottie in reply to wordzo]

Yes I know what you mean! I certainly used to drink more than my fair share that’s for sure but one of the very few plus sides of AF has been that I have completely cleaned up my act in all sorts of ways and now apart from the dreaded AF I am probably healthier at 65 than I was for most of my younger adult life. I do console myself with that thought. X

[wordzo in reply to dedeottie]

Glad to hear you are looking after yourself and in good health :D. Look after yourself and thanks for posting.