Eliquis: Seeing that a large number of... - Atrial Fibrillati...

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Eliquis

pusillanimous profile image
78 Replies

Seeing that a large number of people are changing from Xarelto to Eliquis as it appears to be safer, I asked my doctor to change me. I have the new prescription which I have not had dispensed yet, and it appears to be for 2,5 mg daily, I see the dosing information on the Internet that people of 80 and under 60g should be prescribed this lower dose. I will be 80 in May and weigh 49.5 kg, so fit that criteria, but I just would like to confirm with other members who are in this category, that they are taking the lower dose. Thank you

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78 Replies
10gingercats profile image
10gingercats

My weight is about the same as yours and age over 80. I take 2.5mg twice daily.

I am refering to Apixaban.

pusillanimous profile image
pusillanimous in reply to10gingercats

Yes Equilis is Apixaban - I think I read the dosage on the web site wrongly, it said reduce from 5mg twice daily to 2.5mg twice daily for the above criteria. I have probably read the prescription wrongly, I'll see when I take it to the Pharmacy on Monday - I expect they come prepacked in the right dose. Thanks for your imput!

meadfoot profile image
meadfoot

I have been asked to change from Rivaroxaban to Eliquis but only because its cheaper not because its safer or better. My GP was open with me that its about it being cheaper. I wont change on that premise. Best wishes.

pusillanimous profile image
pusillanimous in reply tomeadfoot

Thank you. I can have either, I live in South Africa and the Generic of Xarelto is available, made by Bayer and looking exactly the same as the original but is cheaper now than Equilis, but I have read all the reports that it is slightly safer - but we need to make up our own minds.

pusillanimous profile image
pusillanimous in reply topusillanimous

Meant Eliquis, Equilis is for horses ha. ha. ha !

Samazeuilh2 profile image
Samazeuilh2 in reply topusillanimous

How is the Xarelto safer? I was unaware of this.

Dovewings profile image
Dovewings in reply topusillanimous

Comment removed by ADMIN

xr1450 profile image
xr1450 in reply toDovewings

THAT is bad advise. If a person is high risk of having a stroke or heart attack this gives you a good chance of preventing it. Doctors do not put people on anticoagulants lightly, people are prescribed them because they need them.

Dovewings profile image
Dovewings in reply toxr1450

Again, read the above

It is a “Big Pharma” racket. Yes, necessary in DVT, but ALL to common now

Peacefulneedshelp profile image
Peacefulneedshelp in reply toDovewings

I feel as you do, but we can’t tell anyone else what to do and never tell someone not to take medications. It’s a decision between them and their doctor and especially with this beast called Afib. In your Bio you didn’t mention if you have Afib or not.

Dovewings profile image
Dovewings in reply toPeacefulneedshelp

Yes@peacefulneedshelp&@riffjack846

To each his own.

After 40 year’s of nursing including Cardiac, Med Surg, Ortho, Neuro and ICU I’ve seen and walked through more than you’ll ever care to know.

Do your research, and be an Advocate for yourself and loved one’s. Too many sheep wander off the cliff just because everyone else says it’s ok. Just like the Covid Injections.

Yes, I had the Hybrid Ablation9 months ago. Today I take a Probiotic & Women’s Multivitamin with a nightly 81mg aspirin. No other pre-existing illness. Eat clean & walk. Peace to all

Peacefulneedshelp profile image
Peacefulneedshelp in reply toDovewings

Dovewings, thank god for people like you. I take a protalytic enzyme that has serrapetase (SP). So I understand your point.

etheral profile image
etheral in reply toDovewings

Hopefully people will actually dotheir own research and not listen to people like you because it's easier or they're predisposed to believe you. How many people will suffer irreversible damage from strokes and Covid because of this?

Dovewings profile image
Dovewings in reply toetheral

Again please don’t be offended.

Just do your research and make adult decisions based on your own patient rights & choices.

Many people have died as a result of bleeding to death after brain hemorrhage in accidents & falls.

Also, many have battled DVT after Covid Vaccines as well as Miocardial Infarction.

Please don’t rely on CDC for all your information. Fauci knew Remdesivir would drown patient’s on Ventilators due to Renal Failure.

Research SAVES lives✌🏻

xr1450 profile image
xr1450 in reply toDovewings

Maybe you should go peddle your anti-medication "Big Pharma" conspiracy theories somewhere else. People are worried enough on here without your BS. You obviously have no idea what you are talking about and all you are doing is worrying people that are already worried. Life expectancy has increased by 50% over the last 70 years due to modern medicine. If it hadn't been for penicillin I would have been dead at 10 years old.

Dovewings profile image
Dovewings in reply toxr1450

xr 1450 Oh dear… No reason to be rude.

No Peddling or Conspiracy here sir. That creates fear.

Be calm, deep breaths, and educate yourself.

No Koolaide served here, just the facts.

Yes mother was on Penicillin at age 17, since the day it was created,

due to Bacterial Endocarditis for approximately 45 year’s.

I wish you long life and wellness ✌🏻☮️🕊️

xr1450 profile image
xr1450 in reply toDovewings

You seem to be very keen on telling people to do their research. My background, Dilated Cardiomyopathy, LBBB and proximal Afib for 21 years and 2 catheter ablation procedures...Trust me I have done A LOT of research.

As far as aspiring and apixaban are concerned maybe it's you that needs to do some research.

"Results: compared with aspirin, apixaban was more efficacious for preventing strokes and systemic embolism in patients ≥85 years (absolute rate [AR] 1%/year on apixaban versus 7.5%/year on aspirin"

"Conclusions: older patients with AF are at particularly high risk of stroke if given aspirin and have substantially greater relative and absolute benefits from apixaban"

pubmed.ncbi.nlm.nih.gov/265...

riffjack846 profile image
riffjack846 in reply toDovewings

Blood thinners like aspirin or warfarin might be bad but anticoagulants like Eliquis etc. are life saving tools in our arsenal against stroke and clots. Eliquis saved my life a couple times.

pusillanimous profile image
pusillanimous in reply toriffjack846

My sister was admitted to hospital for a gall bladder operation - she had AFib as do myself and other 3 sisters - its familial. They could not get her heart rate down for the operation , so they sent her home with a packet of aspirins shortly afterwards she had a stroke. This was a NHS hospital.

oscarfox49 profile image
oscarfox49 in reply tomeadfoot

'Cheaper' maybe but Eliquis is far from cheap! "The average retail price of Eliquis without insurance is $696 for a 30-day prescription of 60, 5 mg tablets, the dosage prescribed to people with atrial fibrillation or serious blood clots like deep vein thrombosis or pulmonary embolism. That averages to about $46 per day or $23 per tablet." I am just eternally grateful to the French health system that I don't have to pay anything at all as those suffering from strokes get it for free.

meadfoot profile image
meadfoot in reply tooscarfox49

Cheaper for the NHS to purchase in comparison to other DOACs according to what they say. Patients dont pay other than prescription charges which again don't apply to everyone. In spite of its shortcomings we in the UK arent burdened with the excessive insurance costs some countries are saddled with. No yet anyway.

oscarfox49 profile image
oscarfox49 in reply tomeadfoot

Certainly true, as I was commenting at the cost in the USA and the fact there people will depend on private insurance. For all its faults, the NHS is a great institution but I must admit I prefer the French system which has far more benefits and a better service, particularly where we live.

meadfoot profile image
meadfoot in reply tooscarfox49

Yes I was talking to our young roofer who had a French girlfriend. He injured his back while living in France and he said the health system there was excellent, quick, very responsive and efficient. Excellent trestment he said.

oscarfox49 profile image
oscarfox49 in reply tomeadfoot

Most people have a 'complementaire' which is an additional insurance which covers the elements the health service does not cover, things in dentistry and opticians etc as well as an element of prescription costs not met by the state. That is very inexpensive and not compromised if you have new medical conditions like AF or stroke, which I think is the case with any private insurance in the UK and elsewhere. When I had a hernia it was 'when can you come?' for treatment, rather than 'There's a two year waiting list', and when I had my stroke a few years ago, I was in hospital, scanned and treated in intensive care within two hours, despite being in a rural area. I just hope the French system continues to be funded and supported as it is at present, but apparently there are already cracks in the system and shortages of doctors and nurses in many large urban areas.

Peteh55 profile image
Peteh55 in reply tomeadfoot

so if they’re basically the same - which they are - why don’t you help preserve the NHS by changing to a cheaper drug. I did.

meadfoot profile image
meadfoot in reply toPeteh55

I resent your inference. You have absolutely no idea of my health conditions or indeed anything whatsoever about me, My highly respected electrophysiologist, one of the top ten rated, in the UK says with my particular cardiac history and other health issues he wants me to stay on rivaroxaban. My GP agrees. Their call was to ask people to change due to cost when I explained my reasoning, topped up by my EP reasoning they were perfectly happy for me to continue as is. Patient needs first was their response.

Peteh55 profile image
Peteh55 in reply tomeadfoot

none of which you said in your comment. You simply said you won’t change drugs because one is cheaper, nothing to do with health reasons to remain on one. Read your comment - maybe if you were clear about your reasons rather than implying cost is not an acceptable reason to change medication (sometimes it is an acceptable reason) you wouldn’t get a response that you “resent”. By the way, politely asking for clarification is not interference it’s free speech.

meadfoot profile image
meadfoot in reply toPeteh55

“Inference”. meaning to infer, - or suggest not “interference”. I wont bother to respond to you further.

Peteh55 profile image
Peteh55 in reply tomeadfoot

good idea

Ppiman profile image
Ppiman in reply tomeadfoot

Also, I believe, the NHS gain special prices from each manufacturer.

Steve

Karendeena profile image
Karendeena in reply tomeadfoot

I was told apixaban was the most expensive!

Nerja2012 profile image
Nerja2012

Female 78, 52kl and I also take Apixaban 2.5mg twice daily. No problems what so ever .

pusillanimous profile image
pusillanimous in reply toNerja2012

Thanks, I must has misread - does the Eliquis come in a pack of 60 tablets?

Nerja2012 profile image
Nerja2012 in reply topusillanimous

Yes it does and because the tablets are in sets of twos on the strip you always know if you have missed one so you always know where you are.

Buffafly profile image
Buffafly in reply toNerja2012

That’s interesting, I politely suggested to my GP that as I am 78 and weigh 50kg and was having problems with bleeding/bruising maybe I could change to 2.5mg dose? She politely refused 😀

Nerja2012 profile image
Nerja2012 in reply toBuffafly

Buffafly. As my Dad died mid 60s from a bleed on the brain I was petrified to take an anticoagulant and for the first 4 years didnt take anything, it was the Cardiologist who suggested the smaller dose , my Doctor never questioned it.

pusillanimous profile image
pusillanimous in reply toNerja2012

Yes my new prescription says 2.5mg - I was concerned that was all for the day, but she had said in our discussion it was 2 tabs instead of one, but that appears to be the description f the backing - I bout if they will cut it in half! The recommended dose is definitely 80 (or so) and under 60kg - the 2.5mg dose, Buffafly! I imagine weight is important - and just for you Buffafly, my doctor is a Pretoria grad !!!!!!!!

Cumbremar5 profile image
Cumbremar5 in reply topusillanimous

I'm in Spain and come under the 2 5 mg criteria 80 years and under 60kg doc said to continue taking 5 mg twice a day not had any afib for years and bruise easily even though I bite the 5mg in half twice a day

Peacefulneedshelp profile image
Peacefulneedshelp in reply toNerja2012

Nerja2012, my mom also had a brain bleed, I too am cautious. I am curious if some of us have family history of week blood vessels as we age and especially in the brain. However, my cardiologist told me since my AFib clears up rather quickly on its own I would not have the same risk as someone who goes for more than 24 hours before going back into sinus rhythm. I keep living as healthy a lifestyle as I can. My mother smoked for many years too, I did not.

Nerja2012 profile image
Nerja2012 in reply toPeacefulneedshelp

Its a strange one P, my Dad who had AF was on warfarin and died from a bleed, my mother also had AF and after what happened to my Dad refused any meds, she died aged 98 and not of AF. We all have our differant stories and life experience , like you I have short episodes of about 4hrs and always self convert, and then its only on average about twice a year so I can honestly say that AF doesnt impact my life at all. But then I'm one of the lucky ones SO FAR ! as I know things can change any time.

Peacefulneedshelp profile image
Peacefulneedshelp in reply toNerja2012

Age does bring on many changes. I was first diagnosed in the mid 80s of a pro lapsed valve. Was on a beta blocker for 12 years and had a huge Afib episode that almost made me pass out, I ended up in the hospital with a long time to convert and a very worried medical team.

Echo shortly after that didn’t show a pro lapsed valve. Crazy, right? I followed dr orders except I weaned off the beta block because it wasn’t helping anyway. But I did exercise, eat right, avoid too much alcohol. I went years without any problems except for occasionally like you. But they started up again almost weekly. I was scheduled for cataract surgery but because I wasn’t on anti coagulant they wouldn’t schedule me without a release from a cardiologist. I did get a release but in the meantime, I found a surgeon that will do the surgery under local anesthesia rather than general. I have to wait until March of this year.

A recent echo once again show a prolapsed valve. So confusing. I am again a beta blocker with very little episodes of AFib.

Cardiologist agreed I don’t need anti coagulants yet. I may some day but if I take too much Quercitin I have bleeding and bruising so I am very concerned.

thanks for the discussion.

Nerja2012 profile image
Nerja2012 in reply toPeacefulneedshelp

P. You where and are still having a very confusing and difficult time, I really feel for you. Stay strong , you will get there in the end. X

SnoopyJ profile image
SnoopyJ

I asked my Cardiologist about switching to Apixaban when I saw him last week, as I’d read that it was considered safer. I’ve been taking Xarelto for the past 11 years with no side effects, however was concerned after reading all the claims that it wasn’t considered to be safe. His comment was that it was 100% safe and that the negative comments were based more on propaganda from rival pharmaceutical companies. I really don’t know what to believe anymore.

oscarfox49 profile image
oscarfox49 in reply toSnoopyJ

No doctor should say that something is 100% safe! Of course it is not. In the end you have to balance the risk against the benefits, and Eliquis is one of the safest pharmaceuticals you can take considering the risks of NOT taking it.

Ppiman profile image
Ppiman in reply toSnoopyJ

I would trust your doctor. The current “issue” with rivaroxaban concerns not the effectiveness of the drug itself per se but it’s comparative effectiveness versus the gold standard, warfarin. It seems in one of the early studies that the INR equipment used for the warfarin component of the study had not been properly validated.

Steve

etheral profile image
etheral in reply toPpiman

Any studies you can point me to showing superiority of warfarin over DOACs, tnx etheral

Ppiman profile image
Ppiman in reply toetheral

I haven't looked recently for comparative studies, but I recall reading the initial large-scale studies showed equivalence. The difficulty, as I read it, is in patient variation, when looking at embolic and haemorrhagic events that occur during studies.

When I wrote the above post, I wasn't aware of the new evidence comparing rivaroxaban versus apixaban. That does look very interesting, and I shall be phoning my GP to ask about this. I am guessing that NICE will be making recommendations for NHS prescribing shortly if the study is considered to be meaningful in its conclusions.

Steve

Stevecat1 profile image
Stevecat1

As per guidelines twice a day Eliquis 2.5mg.

In my mom case she was initially at 5mg twice a day and was lowered to 2.5mg twice a day as she was under weight and turned 80.

An error by another heart doctor earlier who was not well informed about Eliquis and thought it was same as Xarelto told my mom to take 1 a day. It led to her getting a stroke. She still recovering.

magnesium helps with her AFib along with Eliquis. We keeps a gap between the two.

God bless, Stay well and strong!

Tapanac profile image
Tapanac

I was told by my EP that apixaban was kinder to the brain and stomach than anything else

Countrydweller2 profile image
Countrydweller2 in reply toTapanac

That's interesting. Did your EP say in what way Apixaban is kinder to brain and stomach please?

Tapanac profile image
Tapanac

Yes he said that it was more gentle (or something like that) and less inclined to a bleed

Peteh55 profile image
Peteh55 in reply toTapanac

my gp said the same.

Ppiman profile image
Ppiman in reply toTapanac

That’s interesting. I’d think that if it’s “less inclined to a bleed”, then it is not as effective as an anticoagulant.

I haven’t seen any evidence of such differences between the various DOAC drugs.

Steve

Tapanac profile image
Tapanac in reply toPpiman

it was 2018 and memory not as good as it used to be. He probably meant haemorrhage?????? I’m not sure just remember “kinder” what I do remember is that on rivaroxaban I kept getting UTIs but apixaban ok touch wood

Pat

Ppiman profile image
Ppiman in reply toTapanac

That's interesting! Well, at least you're not having that discomfort. My friend's wife gets those rather regularly.

Steve

Buffafly profile image
Buffafly in reply toPpiman

I understand your thoughts but I have wondered if the ‘relative safety’ of eliquis is based on taking it twice a day so the effectiveness is more evenly spread, whereas possibly xarelto needs to be a bit stronger initially for the effect to last 24 hours. I am happy to be told (by someone more knowledgeable obvs) that I am talking rubbish!

Ppiman profile image
Ppiman in reply toBuffafly

Now that's a thought. I have read that the body somehow or other achieves a "steady state" with many drugs, but I don't know how.

Steve

etheral profile image
etheral in reply toPpiman

Certainly not with anticoagulants

Ppiman profile image
Ppiman in reply toetheral

That's interesting - thanks! I've just read several studies looking at rivaroxaban and apixaban. It's hard going indeed to understand the complex pharmacokinetic data. The drugs both do seem to be said to reach a "steady state", however.

Steve

etheral profile image
etheral in reply toBuffafly

Sounds logical..etheral

Cos56 profile image
Cos56

I am 66 and 170 ponds. I take 5 mg of Eliquis twice a day. I asked about a lower dose and was told that’s for older people.

DKBX profile image
DKBX

I’m sticking with Xarelto as it’s worked well for me for ten years. Once a day rather than twice is easier to remember. Reading the actual medical literature on the two drugs shows me that Eliquis has only a slightly better profile for safety but equal effectiveness. Cost for me is equal. So convenience wins.

Afibflipper profile image
Afibflipper

Copied from the BNF (British National Formulary)

Apixaban (Eliquis) copied from the BNF (British National Formulary)
Axex profile image
Axex in reply toAfibflipper

I‘m 77 and currently taking 5mg Eliquis twice daily ,I weight 170lbs. I’ve been happy on this for the last four years .Last week however I had a letter from GP surgery saying they were changing my prescription to Edoxaban 60mg once daily (another blood thinner but not the same ). I‘ve looked it up but there’s not a lot of helpful info out there. Has anyone else had to swap ?

Afibflipper profile image
Afibflipper in reply toAxex

Came across this - don’t know if it completely relates to this thread - I’m happy on Eliquis as it’s caused no problems unlike most drugs I try - if you are still under a consultant they may have the answers/be able to request Eliquis if there is a viable argument to stay on it - a few of my prescriptions state ‘as per Dr/Consultant, Professor ….(name)

pharmaceutical-journal.com/...

Axex profile image
Axex in reply toAfibflipper

thanks Afibflipper… a letter to surgery and consultant sounds like the next move . Apixaban side effects for me …are easy bruising and bleeding but that’s normal. Phoning takes almost as long and only gets you through to reception ! If it works don’t change it . I’m not sure though who has the final say and makes the choice… patient GP or consultant ?

pusillanimous profile image
pusillanimous

Thanks for the interest everyone has shown. I decided to go to the pharmacy this morning to have my new prescription filled. Eliquis 2.5mg is obviously less prescribed here in SA as they had to send to their other branch for a box. The prescription definitely said 2.5mg daily, so the pharmacist had to phone the doctor when I showed her the recommended dose and comments from members here !. The doctor said she prescribed the low dose because she was waiting for my liver results before upping it, but agreed to the 2.5mg twice a day. I think she just slipped up as there does not appear to be any mention of liver in the instructions and I have been taking Xarelto for 5 years. No mention of waiting for results was made at my consultation !. Anyhow, it is sorted and I have a box of 60 x2,5mg Eliquis to start on Monday !

Redmakesmehappy profile image
Redmakesmehappy

I am in my 80’s and I am taking the 2.5 twice daily. Have been on it couple years. Good luck!

pusillanimous profile image
pusillanimous in reply toRedmakesmehappy

Another thing that makes me happy, having read the package insert carefully, is that you can take it either with or without food - much more convenient !

I am 76 years old, weigh about 78 kg and my prescription for Eliquis is 5 mg two times daily.

you are quite a bit lighter in weight but I’m surprised that he doesn’t prescribe that smaller dose twice a day instead of once a day.

pusillanimous profile image
pusillanimous in reply toDesertTrailRunner

Thanks Desert, it has been sorted so that I do get 2.5mg twice a day - I think it was an oversight by my lovely GP and she has rectified it , I have been seeing her for 15years and she knows I keep a close eye on things, I go to my consultation with y own file of information, Lol. It's an easy mistake for a GP to make, she is dealing with hundreds of conditions, I have only a couple to keep myself informed about !

SueMarst profile image
SueMarst

I am a female 74 years old. I didn’t know much about Afib when I first went into Afib.

I was started with Eliquis about a year ago. It made me so drowsy & weak feeling even with getting 7-9 hours of sleep every night.

My doctor changed me to Warfarin plus blood test once every 6 weeks last fall. No side effects from it. But, I’m still exhausted & so tired. Then I read an article:

“Atrial Fibrillation Symptoms (Afib)A few people having atrial fibrillation sometimes do not experience any symptoms and stay unaware of their medical condition until or unless the doctor discovers the condition of atrial fibrillation during the physical examination. While some of the patients who suffer from atrial fibrillation experience the following signs and symptoms:General Fatigue:General fatigue refers to the feeling of exhaustion or tiredness because of a lack of strength or energy in the body, and this symptom is very common in the condition of atrial fibrillation.

Although there might be several factors that result in the cause of general fatigue or tiredness, in the case of atrial fibrillation, the blockage in blood flow leads to the frequent complaint of frequent fatigue. Due to the abnormality in the heart rate causes the accumulation of fluid in the lungs, results in fatigue, which adversely disturbs the daily routine of atrial fibrillation patients. There is a blockage in the supply of oxygen-rich blood from the heart to other body organs due to atrial fibrillation, which ultimately affects the physical stamina; thus, a person experiences frequent episodes of fatigue and exhaustion.”

My cardiologist put me on Metoprolol 50mg 1/2 twice a day & Amlodipine 5mg 1 x a day last fall. This month I was taken off Metoprolol (might be the culprit of my fatigue) & now only take 1 pill a day of Amiodarone plus I take diltiazem.

I’ve never felt a flutter, pain or ache. Not been aware of Afib. In 2015 during my colonoscopy the monitor show I was in Afib. I wore a monitor for 24 hours, nothing happened. In 2020 when being hooked up to monitors for my colonoscopy I went into Afib, so the colonoscopy procedure was cancelled & I returned in 2022 for colonoscopy & everything was fine.

Last September I was having cateract surgery, when being taken to recovery the monitor showed I was in Afib. Nurses tried to get my heart rate down, then EMT took me by ambulance to the hospital ER. I was in the hospital for 4 days while getting my heart rate under control.

Right now I am wearing a 30 day heart monitor which started on 1/19. So far nothing has come up on the monitor.

pusillanimous profile image
pusillanimous

Like most of we Afibbers. I am of the old generation where we were sent to the library to research for our essays in 6th Form. Now we are retired our computers have become our libraries, and we have time to research and sort out the wheat from the chaff. I found this very recent study most interesting and I quote: 'Direct oral anticoagulants, or DOACs, have been found to be safer than warfarin for patients with atrial fibrillation. A new study published in November 2022 in Annals of Internal Medicine found apibaxan to be the safest blood thinner among DOACs, including dabigatran, edoxaban and rivaroxaban. Apibaxan was associated with the lowest risk of gastrointestinal bleeding.

pusillanimous profile image
pusillanimous

Just one more question. I start my Apixaban on Monday - do you all make sure you take the tablets 12 hours apart, e.g 5pm for pill No1 and 5am for the second?

Buffafly profile image
Buffafly in reply topusillanimous

Sort of, if I take one late for some reason I don’t stress about it but I chose a convenient time both ways and try to stick to it.

Stevecat1 profile image
Stevecat1

Approximate does not have to be exact 12 hours, Example my mom sometimes takes her 1st tablet 10am sometimes 12pm and the second tablet at 9pm sometimes 11pm. Each tablet power last for 12hrs, Avoid big gaps

pusillanimous profile image
pusillanimous in reply toStevecat1

Thanks Steve. I'm a bit of an OCD person !!!!!!!

cpap profile image
cpap

Normally it would be for 2.5 twice daily, as the half life of the med is only 12 hours. I am 83 and my doctor is changing me from warfarin to Pixaban/Eliquis next week.

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