Hi Everybody. I don’t post very often but really enjoy the wealth of information I have picked up here. I could do with some advice please. As I am now 65 my cardiologist wants to start me on Apixoban as I have AF. I also take Flecainide and my AF is very well under control. The problem is the dosage of Apixoban. I suffer badly from side effects with most tablets as I am not a very big person. The cardiologist agreed that I could go on a dosage of 2.5 mg twice a day as my weight is only 52 kg. His , and my understanding , was that this was fine as long as your weight is under 60 kg. However the pharmacist in my surgery is not happy with this dosage as she says you have to be over 80 and under 60 kg to have a reduced dose. I am seeing her in the surgery next week to talk this through. My question is - who should know best , my cardiologist ( who I have found to be really helpful ) or the pharmacist ? Also is anyone else , my weight , on this lower dose ? Thanks very much, any advice would be appreciated.
Apixoban dosage.: Hi Everybody. I don’t... - Atrial Fibrillati...
Apixoban dosage.
My understanding is that it is either not both. Much as I respect pharmacists I think your cardiologist knows best. Apixaban should be fine for you at the lower does if that is what he says.
If you click on the link below you will find everything you need to know about taking Apixaban…
cks.nice.org.uk/topics/anti...
Sadly that link only works in the UK. I too would use the Cardiologist. I am about 60K (125lbs) and they put me on 5mg twice a day. I am getting a Watchman tomorrow so I can finally get off the Apixaban. I am anemic and i think this is part of the problem.
Good luck with with the procedure, it’s quite rare here in the UK, so I think a lot of people would appreciate hearing how you get on……..
This is the BNF/Nice recommendation for dosage for AF:5 mg twice daily, reduce dose to 2.5 mg twice daily in patients with at least two of the following characteristics: age 80 years and over, body-weight 60 kg or less, or serum creatinine 133 micromol/litre and over.
So the pharmacist is right (they should be) but your cardiologist obviously believes a half dose is better than nothing so a good compromise.
I weigh 50kg and I’m 77 so still on 5mg (my kidneys are ok at the last count). I also find a smaller dose than recommended seems to be better for me but I haven’t noticed any side effects from Apixaban.
I'm always inclined to believe the Pharmacist. I once said to my pharmacist who picked up a conflicting drug problem that I felt maybe doctors should diagnose and let the pharmacist prescribe (given all the background information of course). He agreed - pharmacists do 3 years of pharmacology, and his estimation was doctors probably with all the other things they have to cover, probably do 6 months.
Thank you for that.I am around 49kilos and 79. My GP surgery checks my kidneys every 6 months and they are still giving me 5mg x 2 daily. My serum creative is only 47.28mL/minute which is nowhere near the 133micromo/litre. As far as I can see it has been around there for a long time. A while back I did ask if I should take 2.5 x 2.
If your concern is about side effects all I would say I react to many meds but I’m ok on Apixaban.
The worst affect would be for you to suffer a stroke from taking nothing. What about trying the lower dose for a week or 2 and if you’re OK - try the 5mg dose?
Hi I'm 80 and weigh 53 kg and take 5mg a day after seeing the manufacturers of apixaban recommended dosage for those over 80 and under 60 kg. My doctor does not agree but I've ignored this. I'm under the Spanish health system being an expat and have to endure annual approval for the continuation of my medication. A reduction in my dosage through this crazy system could result in cessation of apixaban ! So just continue to receive the 5mg twice tablets but just take one 5mg tablet daily.
The short half life of apixaban puts you at risk from this regimen. Probably better cutting them in half or taking 5mg twice a day.
Thanks wondered about that my neighbour a retired pharmacist also suggested as such. Thanks for that advice. Don't think they are soluble.
A warning which may not be relevant but Im on apixaban and after 2 cardioversions, my urine has been full of blood and i've then developed acute urinary infections. This is one of the recognised possible side effects but is rare. ( Im presently trying to get a consultation to discuss this.) So err on side of caution if you can!
interesting, I have often wondered if it can affect the kidneys =:0
TopsyJones. I'm Female 77, 52kg and also taking 2.5mg Apixaban. Cardiologist was ok with it but not the pharmacist.
Apixaban is a DOAC and is a popular anticoagulant that is prescribed to individuals with AF. The dosage will be assessed by your doctor and take into account your personal risks such as weight, age and any other underlying health conditions. You may wish to download the 'Apixaban' factsheet from the patient resources on the webpage : heartrhythmalliance.org/afa...
Hi Tracy. Thanks for that. The way I read the advice on that sheet is that any of the three could be offered a lower dose. Have I read this correctly ?
“The recommended dose of apixaban is 5mg twice daily. If you are over 80, have low body weight or impaired kidney function, you may be offered a lower dose of 2.5mg twice daily.”
Apixaban is rapidly absorbed by the body which is why it is recommended over a twice daily dose, if you have any concerns about your dosage, perhaps speak to a Pharmacist for their medical advice. My apologies, I am not medically trained and cannot offer advice on an individual basis.
I said the same thing to my Dr and Consultant but the Consultant said it was both, not either or. The consultant put me back on 5 mg twice a day as he said that gave me better protection from a stroke. Remember that Apixaban does not give full protection anyway, as there is still a risk. I'm going to stay on the 5 mg twice a day for as long as I can. (even when I turn 80 in two years time, unless my blood tests show otherwise.)
All the best.
Roy
Thank you everybody. I really appreciate the fact that you all went to the trouble to give me an answer.
I was on Xarelto 20mg and developed bleeding under the skin and from the uterus. I was changed to Eliquis 2.5 twice a day but am still getting a lot of bleeding under my skin on my shins. Am thinking of asking to try warfarin to get rid of this horrible mess. Has anyone else done this
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