Edoxaban v. Apixaban

[Lakky12]

I’ve just had a message from my surgery asking if I want to discuss swapping from Apixaban to Edoxaban. Having done a little research it appears Edoxaban is a much cheaper drug, so I can understand why my surgery want me to consider swapping! However, my motto is ‘if it ain’t broke, don’t fix it’ - so unless there are huge health benefits to be gained I won’t swap. Has anyone else had a similar request, or actually swapped, and if so what was the deciding factor? Thanks!!

[bantam12]

I wouldn’t swap either, I have done with one of my other meds and it didn’t go well so I requested to be swapped back, it’s now on my notes to stick with whatever I’m on !

[Hidden]

I think you will find that this is being done to save money. As I understand it, Edoxaban is generally tolerated well but if Apixaban works for you, I’d also be inclined to leave well alone. Very often they emphasise the benefits of only needing one dose a day……l

[Lakky12 in reply to Hidden]

yes the old cynic in me makes me think it’s a sales pitch to save money. Touch wood, I have no problems with taking 2 Apixaban a day, so I’ll continue. I might have a chat with the surgery pharmacist just to see what they say, but I don’t think I’ll be persuaded…..

[Lakky12 in reply to Hidden]

sound advice, thank you. I agree - I don’t want to rock the boat!

[javo123j]

I did change from apixaban to edoxaban about 12 months ago and not noticed any difference. It has suited me as I was forgetting the evening tablet quite frequently. As for the cost, I believe the FDA have approved 2 other companies to make the drug but Bristol-Myers have gone to court to stop them. No wonder as they make around £9 billion a year from the drug. Case is expected to drag on until 2026/8

[Lakky12 in reply to javo123j]

I’m not surprised Bristol-Myers have taken it to court in that case! Shame money is often at the back of decisions rather than what is best for the patient. Thanks for replying - more food for thought!

[javo123j in reply to Lakky12]

I might be wrong in that the information I gave looks like it referred to the USA. The patent officially ended in 2022 and I believe Teva are making it in the UK now. pharmatimes.com/news/teva_u....

[Lakky12 in reply to javo123j]

ah ok, thanks for the clarification.

[PollyDoodle]

Like you, I had a call from my surgery asking me to change due to costs. This was early last year. What has surprised me is that other friends with the same surgery, and those in other Dorset surgeries are still on Apixaban, so I don't understand what is going on.I've not had any problems with Edoxaban. I'm assuming, hoping, it's equally as good.

[Lakky12 in reply to PollyDoodle]

that’s strange! I think I will have a chat with the pharmacist and then decide, although my gut feeling is still to stay with Apixaban. Thanks for your reply!

[Hollis555 in reply to PollyDoodle]

Before I got the telephone call I had a message to ask how much I weigh ,I believe if you're under a certain weight it not suitable,that could be why ?

[Chuyueling in reply to Hollis555]

My mum is incredibly light and is on edoxaban. Hope that isn't the case but you never know. :/

[Chuyueling in reply to Chuyueling]

Just read the article below, it says edoxaban may be less effective in overweight patients! Or at least, there are fewer studies to demonstrate its efficacy in obese patients.

[Hollis555 in reply to Chuyueling]

Ah ok I got it the wrong way round ,thank you for the correction 😊

[Hollis555 in reply to Chuyueling]

OK maybe its if your over a certain weight 🤔

[Lakky12 in reply to Chuyueling]

I wonder if going forward, anyone newly diagnosed with AF will automatically be given Edoxaban, the cheaper option….

[SCCDL in reply to Hollis555]

I asked my PA about switching to a smaller dose of Eliquis (thinking it might savey $$) and she said that you have to be over 80 years and less than 130 lbs to go to the smaller dose. I don't qualify. But am intrigued by the mention of Edoxaban...

[Lakky12 in reply to SCCDL]

there’s a really good article that appears further down these posts - makes interesting reading …

[Duncklco]

I swapped about 9months ago, no problems with edoxaban, was told it was considered more suitable for af patients .

[Hollis555]

Hello ,I also had a call ,I've agreed to swap,I've been told if I have any problems with Edoxaban I can go back to Apixaban, so I was happy with that.

[Lakky12 in reply to Hollis555]

hopefully you’ll be well monitored and not have any problems . You’re obviously better at making decisions than I am ! Hope it goes well.

[SCCDL in reply to Lakky12]

Thanks for the link!

[ozziebob]

Here's an article, previously Posted, explaining the rationale of switching to Edoxaban ...

pharmaceutical-journal.com/...

[Chuyueling in reply to ozziebob]

Thanks for this.

[Cally53]

No call, just a letter telling me they are going to do it! Grr! Am waiting to speak to my GP about it.

[Lakky12 in reply to Cally53]

that’s so bad! If you’re not happy - and I would t be - with that directive, challenge it!!

[Cally53 in reply to Lakky12]

I did, and have had my Rivaroxaban reinstated.

[Staffsgirl]

Yes, same here. The text tried to imply that the change was because of the benefit in needing to only take one a day. I only take one a day of my existing Anticoagulant!

I wrote a very careful and considered email to my GP giving my many reasons for not changing my Anticoagulant. The last of many good reasons was: I don’t want to rock the boat!

I suggest you do some research about Edoxaban. I did, and found numerous arguments against the change for me and my health situation. Some of the listed side effects are conditions I already have.

Good luck. My GP, by the way, has agreed to my request to remain with current Anticoagulant.,

,

[Lakky12 in reply to Staffsgirl]

glad your GP agreed to keep you in your current choice. I suppose like everyone, GPs are trying to making budgetary savings. But sorry, I don’t think I’ll be helping my surgery do that!

[Rumblefeet]

Didn't get on with Apixaban and often found myself forgetting the second tablet as well. Have been on Edoxaban for almost 18 months and it's fine. If it's cheaper, why not go for it?

[Lakky12 in reply to Rumblefeet]

good point, but it’s Sid’s law if I swapped I’d have a problem with it! Glad you get on with it ok.

[Qualipop]

Well said and well done for sticking to your guns. If it ain't broke don't fix it.

[Lakky12 in reply to Qualipop]

thanks very much! 👍🏻

[Cat04]

Is there now an antidote to edoxaban? There is for apixaban.

[Lakky12 in reply to Cat04]

that’s interesting - I didn’t know that! Will investigate further - potentially another reason for me personally sticking with Apixaban.

[Cat04 in reply to Lakky12]

My argument is that my consultant cardiologist/cardiac surgeon put me on apixaban so why should a gp or pharmacist overrule the consultants. Surely the consultants know best.

[Lakky12 in reply to Cat04]

I’m going to ask my cardiologist for her opinion 👍🏻. Thanks for your reply - very valid point!

[Cally53 in reply to Cat04]

Still no reversing agent licensed for edoxaban.

[Lakky12 in reply to Cally53]

that’s a massive consideration to take on board - thanks.

[Staffsgirl in reply to Cat04]

As yet there is no licensed antidote for Edoxaban.

[terrypaul2]

my surgery didn’t give me the option just informed me my repeat prescription would show the switch from rivoxaban to the new one.

[Lakky12 in reply to terrypaul2]

it’s strange that there isn’t a uniform approach to the question of switching. Are you happy to switch?

[terrypaul2]

willing to try it if it saves nhs money.

[Lakky12]

that’s good of you. Hope it’s ok for you.

[Stratton-sully]

Hi Lakky

Talk about coincidence I had a letter this morning

switching me from 5mgs of Apixiban twice a day to 60mg to 60mgs of Edoxaban once a day on my next prescription renewal, yes of course it’s cheaper, I entirely certain the main objective as I’ve had rectal bleeding and took an Apixiban holiday for a week as I couldn’t get hold of a GP for a week and didn’t get though the following week and decided to just take half dose as the bleed had stopped and after a another week full dose of the bleed returned.

I mentioned this to the Pharmacy on the Saturday and 9.30 Monday morning the elusive doctor phoned and said she had made an appointment to see a male GP at 2 pm

Blood test followed and should be back now

And I’m still on just 5 mg with every second day 10 and no bleed.

[Lakky12 in reply to Stratton-sully]

so bad you couldn’t see a GP sooner. Hope everything is ok. I definitely need to do more research before I even consider switching.

[riffjack846]

My only hesitation would be that Edoxoban has no antidote for excessive bleeding if it occurs where Eliquis does.

[Lakky12]

thanks For this - well worth knowing.

[7473]

Hi , had same request to change last month.Open about the cost element but what swing it for me was only take once a day. I kept forgetting the tea time dose. Three weeks in little change , still bruising and bleeding as before.

[Lakky12]

sorry to hear you have problems. I’m pretty good at remembering to take my little stash of tablets - I use a dosset box and have permanent alarms on my phone morning and evening.

[momist]

I was also asked to switch to Edoxaban, but I demurred and they instantly accepted that. When later I asked the arrhythmia nurse in a telephone appointment about it, they instantly said "No!. Your EP put you on Apixaban as he thought that was the best drug for you". I'm happy with that.

BTW, I'm in the UK and yes, I have recently been having Apixaban 5mg tablets made by Teva, not the Eliquis brand I have previously been taking.

[Lakky12]

that’s really good to know, thank you. I’m so glad I posted my question on here - I’ve had some brilliant responses - really helpful. Your reply has reinforced my gut instinct to stay on Apixaban!!

[cotesdurhone]

Hello I was taking 5mg apixaban two times a day but often forgot the evening tablet.I mentioned this to the doctor and he said he would change me to edoxaban because it had a longer half life and I would only need one 60mg tablet per day. Ok after a month seems to be no side effects.