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Alcohol and Apixaban

Alan_G profile image
37 Replies

although this could apply to all anti-coagulants. What are peoples' feelings about drinking alcohol while taking apixaban. I must admit I hadn't given it much thought until I researched a few articles stating it is inadvisable and could causes problems such as internal bleeding.

I only drink alcohol moderately but have had a couple of days this summer where I've drunk more than I usually do. These articles are now making me think I should be more restrained in how much I drink when going out.

I've been on apixaban for 5 years and drunk alcohol in moderation during that time. I have suffered no gum or nose bleeds but am feeling these articles may be a bit of a wake up call.

What do people here think about it?

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Alan_G profile image
Alan_G
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37 Replies
Teresa156 profile image
Teresa156

Hi Alan,

I’m sure others will come along soon….I don’t take anti coagulants yet as my CHADS is 0 currently, but I’m sure, as you probably know, that having Afib, whether paroxysmal or anything else, the general feeling is it’s probably to avoid alcohol as much as possible, purely due to the Afib alone, whether on anti coagulants or not.

I never thought alcohol was particularly a trigger for me, but I’ve had none for nearly a year now ( and I used to really like a glass or two of Prosecco or wine 😔) it was hard initially as it was missed, but I’ve got very used to it. I haven’t had an attack for months now…..whether that’s had anything to do with it or not, I don’t know, but I very much doubt I’d go back to it, the way things are.

Teresa

Alan_G profile image
Alan_G in reply to Teresa156

Thanks for the reply Teresa. Initially, 10 years ago, I put alcohol down as one of my triggers and stayed away from it for a while. However, I've been drinking in moderation for the last 5 years and don't feel my occasional episodes are caused by alcohol. Even when I temporarily gave up alcohol I'd still get episodes. I'm more concerned about the possible effects of mixing alcohol with apixaban.

Teresa156 profile image
Teresa156 in reply to Alan_G

Hi Alan,I do see what you are saying…but thought I’d just mention it anyway and that I didn’t think it was a trigger of mine particularly, but staying away seems to help generally. I’m sure others will come along soon 😊

BobD profile image
BobDVolunteer

Yes alcohol increases the effect of all anticoagulants and increase teg risjk of bleeding but more importantly is often a cause of AF so best avoided in any quantity. .

Bagrat profile image
Bagrat

Moderation is a moveable feast! When I was working when it came to drinking and smoking, we allowed considerable leeway upwards.I'm on apixaban and probably have one glass of wine or sherry a month. My OH in permanent AF on warfarin 2 pints on Thursdays ( 3.9%) and maybe a bottle of Timothy Taylors twice a week in addition.

Our now retired GP when I was on Warfarin said an odd glass of wine should be ok, he was of the doctor knows best variety but always reflected back what you'd said so you could correct any misunderstandings.

javo123j profile image
javo123j

I was always a social drinker, maybe heavy drinker, but had been afib free for over 2 years. I had an attack of afib just after getting Covid and stopped drinking. It made no difference to me getting now frequent attacks of afib so now I drink. I think in the end each individual has to make their own decision. As for anticoagulants i have never really thought about it. It must affect it in some way.

CDreamer profile image
CDreamer

I think it wise to moderate alcohol intake to occasional small beer/wine.

You can stroke out from bleeds as much as from clots so balancing risks whilst still enjoying your life, in my opinion, is important.

I don’t think anyone can give certainty on this because it comes down to choices we make.

waveylines profile image
waveylines in reply to CDreamer

I wish my doctor would listen to that......my bleeding from ati coags is constant........and really I felt I was more likely to die of bleeding on anti coags then die from a stroke off them. In the end ended up on a reduced dose.......still bleeding.....and these days despite regular tooh brushing electric. Swilling twice daily with Corsodyl, my breathe smells, my gum erosion is horrendous, constant taste of metal and doubt my teeth will last much longer. They were perfect before this treatment was started two years ago. Am also covered in bruises.......despite all of this a fear of a stroke drives me on to continue them....... I feel am being conned but darent stop.

Becksagogo profile image
Becksagogo

Alan I gave up alcohol when diagnosed with heart failure and to be honest I don't miss it because there are so many good non alcoholic drinks out there. Just watch the sugar content if you are on the heavy side!Becks, peroni, cobra and Heineken all do good no alcohol alternatives and you can now get Berry ciders and gin .

They are worth a try!

Maggimunro profile image
Maggimunro in reply to Becksagogo

Yes I agree, there are some really good no alcohol beers around. In this unusually hot summer we have discovered Moretti zero, which is a good thirst quencher in the early evening.

Becksagogo profile image
Becksagogo

Ooh. I'm always open to new brands, is that a lager?

Sfhmgusa profile image
Sfhmgusa

It is certain that alcohol has adverse effects when drunk in quantity etc. however equally certain to me is that it is a real pleasure in life. I have moderated my intake from 40 units a week to around 20 ( two bottles of wine equivalent over a week) after my successful ablation ….and I just accept the risk. Afib recovery is about QOL and for me a special dinner with wine is a lot better than without. Alcohol never triggered afib pre ablation , so as many have said I think it is a very personal choice. Not in any way a black and white issue.

Steve

Ppiman profile image
Ppiman

Enjoy your occasional drink. I do. It's safe. This hot year has coincided with Waitrose selling the world's best gin, Chase GB, for just £20.00 a bottle (usually well over £30). How perfect is that?

ncl-mon.nhs.uk/wp-content/u...

Steve

secondtry profile image
secondtry

Alcohol consumption decisions depend on how cautious you are. My approach was take out everything that might contribute to an AF episode, so alcohol went. Miss the Guinness but not the AF!!

MisterMagoo profile image
MisterMagoo in reply to secondtry

Have you tried Guinness zero? Taste wise, it's indistinguishable from the real stuff

secondtry profile image
secondtry in reply to MisterMagoo

Thanks, will do when I finally crack 😂

FindingCaradoc profile image
FindingCaradoc

Hi - I’ve been on Apixaban for 4 months now (following a mild heart attack and going from paroxysmal to persistent AF) I do like a drink and my alcohol intake since the pandemic and retirement in 2020 had crept up to over 40/week - none of the medical professionals I have spoken to have told me not to drink at all in my new reality, rather keep it moderate and stick to the guidelines- so I’m presently managing 16/week and aspiring to the 14! I do like quality beer and wine and would find giving up completely very hard, As others have said there’s some good low and no alcohol beer out there now (and distilled botanicals) which is a big help - but still haven’t found a decent low alcohol wine unfortunately!

LaceyLady profile image
LaceyLady

I’m a trained sommelier level 1, so I enjoy my wine. I don’t drink every day, just on occasional days and don’t have a lotAs I can’t due to natural limit 😜

I became a T2 diabetic, not due to weight, inheritance or over indulgence, most like Covid. I’ve enough life limitations and as my Consultant Endocrinologist said ‘you’ve got to live’! So I’ll continue to enjoy my wine. Cheers

Brancaster1 profile image
Brancaster1

Hi Alan,

I initially declined Apixaban as I knew that I could not give up alcohol. My consultant and GP persuaded me that I should take Apixaban but to drink in moderation. No binge drinking!

I monitor my alcohol units and still enjoy a couple of gins and a glass or two of wine. So far, so good!

Jim

Auriculaire profile image
Auriculaire

I have one small glass ( a sherry glass) of wine with my principal meal . If we go out to eat we order a half bottle but rarely finish it . To not drink wine with my meal would feel like terrible deprivation ! I do not think it affects my afib as these days attacks are very random rather than connected to eating a meal with wine. The last one came on after I felt my blood sugar had dropped suddenly . I drank an Actimel quickly straight from the fridge and hey presto!

Alan_G profile image
Alan_G in reply to Auriculaire

A cold, sweet drink like J2O taken out of the fridge is the one thing I know will give me an afib episode. It's cold drinks that do it to me rather than alcoholic.

Ducky2003 profile image
Ducky2003

Alcohol can exacerbate the affects of quite a few medications, anticoagulants being one of them so I choose not to drink but perhaps a chat with your GP may help you decide.

Alan_G profile image
Alan_G in reply to Ducky2003

I think the problem is that with alcohol being a blood thinner, it can make you even more susceptible to a bleed.

Ducky2003 profile image
Ducky2003 in reply to Alan_G

The other meds I'm on also have increased potency with alcohol so easier for me to stick to Becks Blue.😊.

Jmc43 profile image
Jmc43

I guess we can see from reading the responses that there are several different approaches to how people handle alcohol and Apixaban. I will add another. I think alcohol is a trigger for me —if I drink too much. I have had an ablation over two years ago, and I am on Apixaban. About 6 months ago, I was not sleeping well at night, waking up two or three times, and often with ectopic beats that morphed into short periods of Afib. So I tested things. I stopped alcohol, and the troublesome night time episodes disappeared. I think had one glass with dinner, and it was fine…and then two…and so on. I discovered that if I have two glasses, there is no effect. If I have more, it gets less certain. So I limit myself to two moderate glasses at dinner most nights. And because I can make a bottle last 3 or 4 days, I only drink really good wine — so there is a silver lining. 😎. Plus, I have not experienced any Apixaban side effect.

Snowgirl65 profile image
Snowgirl65

Ah yes, the age-old question for a-fibbers -- to drink or not to drink. Unfortunately, I had to swear it off when I realized it was a trigger. I didn't even think about how it interacted with my Xarelto. I miss it, but a wise choice for me.

Alan_G profile image
Alan_G

Thank you for all the replies. My occasional afib episodes tend to be totally random and can occur at weekends when I have no alcohol to drink. As I said, earlier, it's sweet, cold drinks that give me a problem. My worry is causing a bleed through drinking too much alcohol. I was at a very moderate level before this weather and then my units per week went up. I'm not going to give up alcohol but bring my units back down below 20.

RoyMacDonald profile image
RoyMacDonald

Your post coincides with me listening to a BBC podcast called "Made of Stronger Stuff, The Lungs" and I would never drink alcohol again under any circumstances. I'm not surprised that it can trigger AF considering how hard wired the lungs are into our bodies and brains, and alcohol can kill you if it's drunk in large quantities as the lungs try and stabilise your blood. I did not understand how many functions the lungs perform until I listened to the podcast.

All the best.

Roy

Alan_G profile image
Alan_G in reply to RoyMacDonald

Yes, but if we reacted to every little bit of medical advice like that we'd be afraid to do anything including eating when you read about the effects of some foods on your body.

RoyMacDonald profile image
RoyMacDonald in reply to Alan_G

Wasn't medical advice, just a description of how the lungs work and what they do.

Yes, I do react to how our bodies work but I'm virtually AF free now. 😀 Not afraid to die but why not live as long as you can if you are enjoying life?

All the best.

Roy

Afibflipper profile image
Afibflipper

Just because there’s no gum or nose bleeds is not a great indicator I’m afraid - increased risk of stroke and I believe gastric bleeds also so in my opinion moderately drinking is too much - switch to small amounts infrequently or tee totalEverybody is different with tolerance - pushing boundaries for one is not the same for the next person

JOY2THEWORLD49 profile image
JOY2THEWORLD49

HiYour H/R and AF are not mentioned to put you into a level.

The latest on anti-coagulants is if you are not persistent AF have the PIP Pill in pocket to prevent stroke.

cheri JOY. 73. (NZ)

Alan_G profile image
Alan_G in reply to JOY2THEWORLD49

hi. I'm lone paroxysmal AF, and have random episodes anywhere between 2 weeks and 3 months apart. They last anywhere between 12 to 18 hours. They are very mild and I hardly feel them other than a slight sensation in my chest. They don't effect what I am going. Sometimes I have to feel my pulse to check if I'm still in A/F or not. I am on apixaban though. I'm not taking anything else. My HR is about 60 to 65 normally, but doesn't go much higher even when I'm in AF.

Alan_G profile image
Alan_G in reply to JOY2THEWORLD49

By PIP do you mean only take the apixaban when you go into A/F? In NR don't bother with it? If that is the advice being given by NICE I'll need to check with my GP about it.

JOY2THEWORLD49 profile image
JOY2THEWORLD49

HiThanx for the question.

Yes, as Radcliffe's latest research state that anti-co-agulant should be used to the minimum.

PIP was suggested.

Because the risk of stroke comes with AF only as the blood can pool with the irregularity of your heart.

Periods used to come virtually on the dot of 28 days. With terrible first 24 hours I was advised by my specialist to get Indocid into my blood stream before it started and most times I did. I floated through the first 24 hours with no pain.

But I guess there is a risk when you don"t know.

I understand that Radcliffe Medical Centre feel that anti-co-agulants have risk. Also unnecessary use of them can be monitored by patients with AF.

You must be good. I cannot feel AF through my hand on wrist vein.

I can feel some pounding when I have climbed a hill. I have to stop and wait for 1-2 minutes.

My notation is the absolute latest and it was from Radcliffe UK. I joined them as I could put down 'nurse'. I can look and see videos etc.

If I had your email address I could send it to you. The link is usually too long to submit it.

cheri. JOY

Alan_G profile image
Alan_G in reply to JOY2THEWORLD49

I found their website and saw something about anti coags but it won't let me view it because it says I'm in the wrong country. It is obviously a US site and I'm in the UK.

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to Alan_G

HiI understood it was based in Leicester and that's UK.

It was sent to me automatically as I joined as a nurse.

I can choose what interests me.

May be we need to wait for it to become news.

Things happen like ..

I refused the automatic dose of Radio Active Iodine after cancerous thyroid and 12 lymph nodes removed. 2 were infected on right.

I was low risk so I said No thanx. My surgeon respected my decision. The endocrine Dr in my triage had trouble accepting this.

For the last 18mths USA top surgeons for thyroid cancer have moved to agree with my stance and that LOW RISK patients can have their say.

I have been through 2 x yearly neck scans and all clear.

In 2005 I also declined Radiation after a DSIC. They found a carcina in a milk duct and removed it. No problems.

JOY

Also I refused to be in Suppression of TSH. She was against me in that. Reading latest surveys that older and heart condition patients should have a choice. Now it is a give to keep not too low in normal and not to high of normal.TSH 2.0 is the ideal level.

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