I have happily taken Rivaroxaban, without any problems, for many years and out of the blue my surgery wants me to change to Edoxaban claiming it’s NHS recommendation. Does anyone know anything about this. I’m not familiar with Edoxaban and wondered if it works in a different way, if side effects are any different or is it purely a money saving exercise. I am slightly reluctant with any changes to my medication as I suffered very badly from all the different AF medications resulting in a very successful pacemaker and AV node ablation. I now only take Rivaroxaban for my AF .
Edoxaban versus Rivaroxaban - Atrial Fibrillati...
Edoxaban versus Rivaroxaban
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mastiff22
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I take Rivaroxaban and have done for many years like you. Back in July out of the blue a GP in my practice rang one evening off all times. She is lovely but not my own GP. She said she wanted me to change to Edoxaban as it is cheaper. She came right out with it no fudging around the edges.
I said I was not prepared to change anything without the say so of my EP who I was seeing a few months later. She said she expected all NHS providers would be changing to Edoxaban due to cost.
My EP said there was a similar directive and as a Trust they would be encouraged to prescribe Edoxaban. He was surprised the GP had come out and said it was cost based even though it was. However he said it was a fine alternative but it was my choice and perhaps given that I have aide effects from drugs perhaps I should stay I am. I have done and nothing further has been said by my GP practice. All part of cost saving and I dont blame GPs for having to raise these issues with patients. They are between a rock and a hard place too.
I was changed from riveroxaban to apixaban but kept forgetting the evening dose. I was then put on edoxaban and had many side effects I hadn’t experienced before. Eventually I was put back on riveroxaban and feel much better. I was told it was cost but not sure?
I chaged from Dabigatran to Edoxaban a few years ago as the Dabigatran irritated my stomach. I also wanted something I could take that was only once a day. I did some research myself and asked my cardiologist to go on Edoxaban. I find it far better and never had any issues.
In your case I would certainbly ask you Cardiologist before changing.
The AFA have some good resources explaining the different anti-coagulants: heartrhythmalliance.org/afa...
This one compares eth available anti-coagulant drugs:chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/api.heartrhythmalliance.org...
There are also separate sheets on each one.
Look at the evidence and then decide for yourself.I understand Edoxoban is cheaper than the other NOACs and GPs are being urged to cut costs ......but try and do what suits you.
I was on Rivaroxaban for 18 months, when I had a (very) small TIA, and the hospital changed my medication to Edoxaban, and I’ve been absolutely fine on it for the last year.
Apixaban has a better profile as it has equal efficacy with lower risk of gastro intestinal bleeds. That is setting aside the fact that if an individual is settled and coping with with a specific drug " If it ain't broke don't fix it". I appreciate the NHS is staggering from one crisis to another ,including financial ones, so can see where they are going with this.
it’s interesting the cost saving question on our medications ..my EP/cardiologist wants me on Amiodarone before another attempt at Cardioversion but my GP surgery refuses point blank to prescribe the medication purely on a costing basis telling me the hospital will need to issue the prescriptions.. I wasn’t aware of any costing to my GP surgery and if so could have a huge influence on medications prescribed.
Always been the case that secondary care prescribe but expect repeat prescriptions to be fulfilled by GP and come out of their budget, it has always been structured this way. Some practices abide by the guidelines whilst other individual GPs tend to stick with their clinical decision, often depends whether or not they are shareholding GP, in my experience. There has been a drive to reduce costs of medication by the CCG’s for the last 15 years. This explains the structure of how GP’s get their funding and up until recently, most GP practices used be run as private business partnerships.
kingsfund.org.uk/publicatio...
What are general practices?General practices are the small to medium-sized businesses whose services are contracted by NHS commissioners to provide generalist medical services in a geographical or population area. While some general practices are operated by an individual GP, most general practices in England are run by a GP partnership. This involves two or more GPs, sometimes with nurses, practice managers and others (as long as at least one partner is a GP), working together as business partners, pooling resources, such as buildings and staff, and together owning a stake in the practice business. GP partners are jointly responsible for meeting the requirements set out in the contract for their practice and share the income it provides.
I changed from Warfarin to Edoxaban during the pandemic. It’s great, no side effects and no monitoring needed.
Ditto. I’ve had no problems at all since going onto Edoxaban (from Warfarin) two years ago.
in reply to Sleepyzz
My GP has tried to get me off Warfarin onto a NOAC and I have refused. She asked me why and my reply was .......... Warfarin is still cheapest and I have no problems with it. If I travel and am due for a test I take my self testing kit with me, even to Australia.
Who is to say a NOAC won't give me more problems than I presently have ? which are none ! Sucking up to big pharma ?
I was on Apixaban but had to stop taking it as I suffered with worsening of gastric issues (I suffer with IBS) I was asked to try Edoxaban 30mg once daily and was told there were other alternatives for me to try if I had any issues. Edoxaban continues to be my anticoagulant and my bloods in respect of my liver and kidneys will be checked every 3 months as I am over 70 yrs old. Apparently if you are younger this blood test would be once a year. So far I am happy to continue with Edoxaban.
This is very interesting. I didn’t realise there could be gastric issues with Apixaban. I’ve got BAM which has got much worse in recent years. I’ll check this out.
hi, i think we are all so different and what suits one person might be a problem for another. I react to some fillers in tablets too and after many years my GP has acknowledged my issues with meds and knows if he wants me to take medication I have to be able to function on them. He will now let me try alternatives if I have a problem. I think once you find something that you can tolerate stay with it. I wish you well. X
My cardiologist favours Edoxaban due to cost but also said Rivaroxaban had some unfavourable research findings in the USA, he didn't specify though.
I’m on edoxaban with no side effects. It’s great. I think I read somewhere that, unlike warfarin, it works as well for women as it does for men.
I changed from Rivaroxaban to Edoxaban about 9 months ago. My cardiologist suggested the change because I had to take Rivaroxaban with food where I can just take Edoxaban with my other tablets in the morning. I have had no problems and it has made life easier. Do what is right for you after talking to your EP
I was changed to edoxaban a couple of months ago. I did have a few side effects for the first month mainly dizzy spells but I'm settled now and for me only have to take tablets once a day
It's about money. A few weeks ago I posted a link to an article which clarified this. If you click on my name you should be able to track it.
I like you have just had a pacemaker and node ablation and last week my GP also wanted me to change from Warfarin to Edoxapan saying that I would find it much easier not having to have the blood tests so often. I agreed but only managed to take one pill and suffered agonising stomach pains for 24 hours. Went back to him and changed to Apixaban and that has been fine. I know we are all different in our reactions so I might be an exception but the GP did say our County had done a good deal with the NHS on the price of Edoxapan.
As we all know, the NHS is under enormous pressure, and like any public organisation paid for by us taxpayers, I would expect it to be cost efficient and look for value for money. In a situation where there is no clinical difference in outcome, they should go with the cheapest option and as patients we should support that. Unless suspected or know impacts of changing, should we not try the alternatives with the proviso that we can change back should there be a -ve impact? There is of course a risk of perceived / psychosomatic impact from a reluctance to change.
I've been on Edoxaban since Dec 2019 after having a stroke. No issues with it at all.
Hi
Edoxaban is now stated as safer.
In NZ in Palmerston North an elderly man died. Suffering a stroke and
then another one in hospital and was found to have kidney problems.
Its been 2 years and the wife wants closure as to why he died.
We are waiting and its on the news here now.
If you are a Uk an We, NZders won the 2022 World Club the womens rugby.
Winning 34 to 31. We were able to convert twice.
But England was winning 14 to nil at the first quarter.
Back to Edoxaban it is the dearest and as yet it is not available in NZ.
I would have it I could. I'm on PRADAXA 110mg x twice day. I chose it as it has an antidote and taken twice a day.
cheri. JOY. 73. (NZ)
I've tried apixaban, rivaroxaban and am now on edoxaban. Touch wood edoxaban suits me the best as no nose bleeds. I see from the AA notes that there are drugs to reverse the effects of rivaroxaban and apixaban but there is no information given on edoxaban. Presumably this should be an issue if there is a policy to move patients on to edoxaban.
I have been on Edoxaban for about 18 months now.
As I was ‘on the cusp’ re age and CHAD score - I discussed pros and cons of anti coags with my cardiologist. My biggest concern was the lack of reversal drugs. He agreed that when these were in their infancy it was an issue, but now practitioners are used to dealing with them and have protocols for patients on these drugs. He also pointed out that the time they remain active in the body is short - emphasising that with Edoxaban, it is only 3 days without medication and you are clear for major surgery.
As much as I hate taking any form of medication, I was persuaded and reluctantly agreed to take the Edoxaban and it’s fine. However, I do ensure that I always have a form of medic alert with me, just so that in an emergency, Drs will know what I’m on and what to do!!
I saw my EP on Monday last week and I told him what I had read previously about changing from Apixaban to Edoxaban. He told me it was not cheaper than Aprixaban and that they are able to use exactly the same reversal drugs as they do for Aprixaban. Apparently the rumours re this began when the drug was first introduced on the market as the notification about the reversal drugs was a little slow being announced. He finished by saying that if I did decide to change, he would have no problems with that decision at all.
Netty
I was interested to see not only l started to suffer with nose bleeds...at the time l was on Rivaoxyban and Clopadogril...every morning on waking l had a bleed...after making enquiries my consultant said l shouldn't be on both and took me off Clopadogril...bleeds stopped....I also was changed from Rivaoxyban to Edoxaban with no problems due to cost..
There is now a generic available for Xarelto, it is cheaper and I have changed to it. It is manufactured by Bayer, looks exactly the same as the original, the packaging is the same except the foil is a lighter brown and the box here in South Africa is labelled iXarola 20 but the details on the box are the same - manufactured by Bayer AG in Germany (and printed in German and English)Leverkusen, for Bayer Edms (South African address) just as the original had. I'm sure it's the same thing, but packed differently. Can't the NHS do something similar or is it something to do with the EU?
Edoxaban is the cheaper option. Our GP surgery tried to change my mum from apixaban to this but I refused and referenced the consultant wanted her on apixaban so they agreed in the end. I believe apixaban is the most expensive but has the lowest risks all round. I am on apixaban too and won't change
My local London based Anticoagulation Clinic now recommends Edoxaban as the first choice option because of these new cost considerations (as admitted by the pharmacist). However, because I had had a previous brain bleed, the recommendation for me was Apixaban (lower brain bleed risk apparently). But Edoxaban is not without its merits, and is well tolerated by many, as reported here on the Forum.
Hi Mastiff22
I have been on Edoxaban for three years with no problems. It is what is always prescribed in Scotland as far as I know. My friend in England was prescribed Pixaban. I keep my weight to just under 60kg so I have the lesser dose of 30mg. An incentive when I want to eat and eat. I believe the anticoagulant effect isn’t long lasting so I take it in the evening rather than the morning before say, working in the garden or using a sharp knife in the kitchen. From the Edoxaban site - “.Edoxaban begins to reduce blood clotting within a few hours after taking the first dose. If you stop taking Savaysa® ( edoxaban) , its effect on clotting begins to wear off within 24 hours for most people.28 Feb 2015“ I did buy myself a bracelet that I am on an anticoagulant.
hi I’m on Edoxaban. Started on 2.5 dose and found I was very dizzy walking up/down the stairs, getting out of bed or up from my armchair. Spoke to my excellent doctor and halved dose to 1.25 and everything hunky dory. No probs
p.s was told that Edoxaban was latest with very little side effects. This proved to be right. As with any medicine you just have to get the dose right.
I didn’t get on with Rivaroxaban. Edoxaban I’m fine with and has the advantage that it only needs to be taken once a day.
a few months ago I had a call from the pharmacist saying that the gp wanted me to switch to edoxaban from rivaroxaban as it was an nhs directive. Never had a response from gp. I found that some part of Scotland had issued a directive but couldn’t find any thing else. It’s possibly safer according to NICE info and FDA or whatevrr in usa but definitely cheaper. However, I’ve had more nosebleeds on this though. By the way, you’ve had many more replies.
can we guess say it’s a cost factor ? Riv is American import . I’m same years on Rvirox . Fine , as no clots and APS negative , I’m reduced to 10 from 20 mg . Feel happy with that . Specialist tried to take me off few years ago. Didn’t offer other as I said NO !! I’m used to it . Doesn’t make me bleed unless to much hot ginger - nose bleed . Noe getting meds review with G P bet she tries also . £££ NHS . ‘IF IT AINT BROKE DONT FIX IT ‘. In UK it was the dreaded ( to me , as all that faffing around testing and clinics NO !). WARFARIN until RIVROX 5 app years ago . USA is ahead in Meds . Only my opinion . I feel safe on it . I do however 4 monthly bloods to see not dancing kidneys at G P . Plus no bleeds . Csn bruise on skin. Hope 10 mg will reduce that . I have APS sticky blood unprovoked clot . I am better and feel better in brain in Riv. I do take it with Slimfast choc skimmed milk shake , as can be harsh on stomach . A meal pretty fast after that . 🙌
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