Apixaban

[Foxglo]

I noticed this week that Eliquis Apixaban has been replaced in my medication by Teva brand, just wondering how this is being received by people. Having experienced previous problems with brand changes with other medications I am initially a bit apprehensive.

[BobD Volunteer]

Why? It is the same drug just a different manufacturer. I've lost count of the number of different forms of some of the drugs I take.

[Foxglo in reply to BobD]

Thanks for information really helpful

[bantam12 in reply to BobD]

Many people have problems changing brands as manufacturers may use different fillers which we react to. Thyroid replacement is a particular medication where changing brands can cause huge problems, thyroid patients (me included) have to where possible stick to a brand that suits them.

[Foxglo in reply to bantam12]

Thanks for reply

[Ducky2003 in reply to bantam12]

Same here. See my reply to Bob as well..

[Ducky2003 in reply to BobD]

Not all brands are the same. Levothyroxine is a common one that can differ but my problem came with eye drops. I have Brinzolomide with no issues for a couple of years but then the chemist gave me a different brand at repeat time and the vision in my left eye blurred almost instantly. The optician and hospital ophthalmology both said it was down to the non active ingredient in the drops. Chemist has it on file to just give me the original brand but my vision in the left eye has not improved to what it was and I also have to take dry eye drops as well now.

[GretaG in reply to Ducky2003]

Many eye drops come with preservatives which, in my case, cause eye irritation. My opthamologist always prescribes from a company that produces preservative free drops. They tend to be more expensive but worth it. So I believe differences do exist.

[RoyMacDonald in reply to GretaG]

Those preservative free ones can be bought at Boots, over the counter for £5 for a box of 30, as I found out when I forgot to take mine on Holiday to Scotland. Hardly expensive in my book. Certainly compared to Apixaban.

All the best.

Roy

[GretaG in reply to RoyMacDonald]

Thanks Roy. I'm in the US so I'm not familiar with those drops. What I was referring to was prescription eye drops for glaucoma which can be very pricey here. I know the subject was apaxiban and different manufactures. I was just using my opthamolic prescription as an example of how drugs can vary by pharmaceutical companies. Sorry I wasn't clear.

[RoyMacDonald in reply to GretaG]

Thanks for the clarification GretaG. I assumed you were referring to dry eye drops which also come with preservatives and without.

I would guess you don't have the Boots chain of chemists in the US as well. Sorry about the confusion and sorry to hear you have glaucoma, it's a horrible condition.

All the best.

Roy

[pd63]

I now have apixaban teva, probably means British Myers Squib's license/patent has now expired and other companies can make it as a generic, same drug, all strictly controlled. My other meds are supplied as generics and suppliers are often changed when I pick them up from the pharmacy

[Foxglo in reply to pd63]

Thanks really helpful

[bantam12]

Teva is usually a cheaper option but if it doesn’t suit you ask to go back to your original brand, I’ve had to do this for 2 of my meds and I will refuse Teva if given as I know Teva meds don’t suit me.

[CDreamer]

Thanks for the heads up, I’ve not experienced change of brand on Apixaban but changing brands on other meds has caused me a LOAD of problems. I’m just hoping that my new GP will be as co-operative as my old practice and specify brands if I have problems. Right now, I’d just be pleased to get any of one of my meds!

[Foxglo in reply to CDreamer]

Likewise for me with Flecainide and Diltiazem. Hoping this new brand is ok. Thanks for reply

[Buffafly in reply to Foxglo]

Diltiazem is one of those where you always need to have the same brand but sometimes a change is an improvement. I was taking Adizem which caused problems but when given Slozem I found it much better and when comparing I found Adizem had additives which didn’t suit me. Then changed to Zemtard by doctor, presumably cheaper, so I read the contents info very carefully …….

[javo123j]

I've been changed from Apixaban to Edoxaban due to costs but I am having problems with breathing. Not sure why. Could be the tablets but not sure

[Chris1945]

Hi, I've been on been on 3 blood thinners now and all of them have had adverse side effects! Was initially put on Warfarin, which as a Vegetarian and lover of all green veggies, was a bit of a nightmare as INR levels were all over the place. So was moved to Apixaban, but within a matter of two weeks I had joint and muscle pain everywhere which was not nice and I have been told by a rheumatologist that this drug can do that. So Edoxaban was the next one and within days I was covered in large itchy rashes, cardiologist took me off that to see what happened and rashes disappeared, so I have to conclude that blood thinners don't like me as much as I don't like them! Temporarily, I am back on Edoxaban but not sure what other alternatives there are!

[Bagrat in reply to Chris1945]

I would say as a veggie, warfarin would be fine if you were consistent in your consumption of green veggies. some people on warfarin take vit K as a stabiliser for maintaining steady INR

[oscarfox49]

I would be terrified if this happened to me! It is the most vital medication we take (after a stroke in my case) and I hate the idea that it could be adapted in some way either with fillers or manufacture of the vital component in ways that made it less effective!

I always believed that one generic drug was the same as another until my experience with a fluoxetine substitute that I could simply not tolerate and always made me feel ill. Once I managed to find the original brand I was taking again, I was fine again. Not all generics are the same! We are the ones who actually TAKE the drugs, why should be listen to doctors and pharmacists who have never taken the cheaper alternatives who just rely on various studies to say everything is hunky dory!

[Foxglo in reply to oscarfox49]

Thank you so much for your reply it is reassuring I am not alone in being a bit concerned. My bad experience was with Flecainide changing brands until I managed to get on the branded version. Best wishes

[Clarrie]

I also have just been given the Teva brand rather than Eliquis which I have had for 7 years. I am going to ask doctor if I can be given Eliquis in the future.

[Foxglo in reply to Clarrie]

Thanks for your reply I feel reassured I am not the only one feeling like this.

[momist]

Me too - I'll see how they pan out, but so far no effects.

[Foxglo in reply to momist]

Thanks for you reply Good Luck

[Hidden]

Thank you for starting this discussion and reminding me of my own particular beef with a Teva replacement medication, which you've reminded me I need to follow up on. I take Liothyronine (T3) thyroid hormone and I have to cut the pill but the Teva version is totally rubbish! It's a tiny pill and the Teva one is slightly rounded and has a hard shell which means that however carefully you try to cut it, it just breaks into pieces, which makes absolutely zero sense since nearly all patients prescribed it are going to need to halve it, like me. The branded version I used to get was flat, not hard, and scored down the middle exactly for halving. I have asked the pharmacist about it but they just say they get whatever is available in the central warehouse.

I think I'll try my GP next.

[Foxglo in reply to Hidden]

Thank you for the reply. I had huge problems prior to an ablation with the random changing of Flecainide brands till I got the Branded version which is why I am a bit concerned about this latest change. I had another reply about problems with thyroid medication you may be able to see. Best wishes

[Lacontie]

Having worked in the Pharmacy business I can tell you that when a brand changes it’s normally because the doctor can prescribe a cheaper alternative saving the NHS money but the efficacy is exactly the same as the ingredients all have to be identical.The large pharmaceutical manufacturers have a number of years exclusivity before anyone can use the formula and sell an identical product.

Think of it like a supermarket version of paracetamol which if it’s the same strength as the well known brand is exactly the same at a fraction of the cost!

[bantam12 in reply to Lacontie]

As you can see from some replies here generic meds are not always identical to branded ones. One of my meds which I had taken for 20 years without problems was changed to a generic and it caused huge problems which both my GP and Consultant accepted was because of the change, once back on branded the issues resolved.

My sister is also a Pharmacist and agrees that swapping from a brand to generic doesn’t always work.

[Lacontie in reply to bantam12]

It is supposed to be identical so if the doctor has prescribed that particularly medication and it causes problems something is seriously wrong with the manufacturers not adhering to the correct agreements and code which is unacceptable …in that I agree with you but it just should not happen!

[bantam12 in reply to Lacontie]

It’s a common problem with many generics. When my IBD med was changed my GP said they try cheaper generics but many people cannot tolerate them so it’s back to the named brand. I will not accept changes now just to save the nhs a few pounds.

[Auriculaire in reply to Lacontie]

The actual drug content is identical but this is not necessarily true for the fillers which probably make up the bulk of the tablet. There was a huge scandal here in France when Merck changed the composition of it's Levothyroxine causing problems for many patients who had been stable for many years. And there was no way that they could be gaslighted ( which the health authorities tried on ) and told they were imagining their symptoms because their blood tests went haywire too. It turned out in the end that this was probably done for financial reasons as Merck took out the lactose in the old pill . They had just opened massive manufacturing capacity in guess where? The country that has the most lactose intolerant people in the world . To hell with the patients in Europe who had been stable on their meds for years.

[Mrsvemb in reply to Lacontie]

The active ingredient remains the same, but the fillers vary from manufacturer to manufacturer. It is the fillers that are causing problems.

I have had this problem with a few drugs. I have compared the ingredients of a few drugs now and they do differ. Both Bisoprolol and Nebivolol have given me this problem. The brand has to be specified on my prescription.

I have proved that one filler causes me bad nausea by trial and error and that is crospovidone. It is used in Edoxaban so I can’t have that.

[Lacontie in reply to Mrsvemb]

Point taken! Never thought about fillers 👍

[Tryfan]

I was told mine was changed as they couldn't source Elquis. Who knows?

[etheral]

Interesting , because Eliquis is the only drug I take that is the original branded version. Maybe they are sending all their production to the states because we pay much more for it than the NHS is willing to pay? etheral