I have just received a phone call from my surgery pharmacist asking me if I would like to change from Apixaban to Endoxaban. I listened intently to what he had to say, it seems I fall into the criteria for doing this change. At the end of the conversation he said ‘ by changing it has considerable advantages for the NHS’ my reply was ‘ you mean it’s cheaper’ he agreed and said they can treat two people with Endoxaban as opposed to only one with Apixaban. I said I would have to do my own research before giving him an answer to which he agreed and said there was no pressure to change. I have briefly looked at research which seems to suggest you are more likely to have bleeding on Endoxaban. The upside is it’s a lower dose and taken only once per day. I just wondered if anyone else takes it and anyone’s thoughts on it. Research suggests it’s the drug of choice for non valvular AF. I personally seem to think it’s because of cost. Any thoughts. Thank you in advance for any replies.
Endoxaban versus Apixaban: I have just... - Atrial Fibrillati...
Endoxaban versus Apixaban
Edoxaban is indeed cheaper and you must be the tenth person so far this month to have posted about similar conversations. Apixaban does have a far better bleed (or non bleed ) profile from what I have seen though I have no intention of changing from my beloved warfarin in any case.
I will say the same to you as I have all the others . Don't be bullied.
Well said Bob, well said. Totally agree.
Thank you Bob. There is absolutely no chance of them bullying me.
I changed from rivaroxaban to apixaban because its better for the digestion I had major problems with 20mg rivaroxaban. Yes it's money, the NHS has a better deal with Edoxaban.
As a matter of interest, is there a specific reason you are on warfarin? It seems like a lot of hassle to me (regular blood tests etc).
Been on it for 18 years with zero issues. ( Long before these new fangled drugs were available) INR very stable and self test each month . If it aint broke don't mess with it.
If you are happy on Apixaban and no clinical reason to change I would stick.
I’m not convinced about the efficacy of once a day DOACs, shorter half life of twice daily Apixaban may have multiple benefits. Just my opinion.
Agree completely. I would much rather be on the twice a day dosing and don't regard having to remember to take the pill twice a day as any sort of hardship- though this seems to be a "sweetener" thrown out by those urging people to change.
Hi FN,
Regardless of your background, regardless of what your GP or any other healthcare professional says ............... think money ............ think marketing ......... think conmen/women ......... that's Big Pharma in the 21st Century ........ profiteers. Not in the least caring of your welfare .... no matter what the advertising men say.
Just call me a grumpy old cynic. 😂😂
John
I can only say I started Edoxaban on New Year’s Eve which is a short time I know but I have had zero side effects . Had blood taken yesterday and I wondered if I would get more bleeding at the entry site than previously but I didn’t . My understanding as to the price is that the NHS decided which drug they wanted and then negotiated with the pharmaceutical company rather than it’s a bargain basement product. The cardiologist who recommended Edoxaban is a personal friend and wouldn’t recommend a drug for me to take in the basis of price . I agree starting or changing a drug is always scary . I take it in the morning as recommended and forget about it . Good luck
When I haf a stroke caused by AF, which I didn't know I had, the consultant advised against once a day anti coag as it takes longer to get out of your system. By taking Apixaban twice a day the risk of bleeding after injury is much less.
so far as I’m aware, unlike A, in case of a bleed there’s no reversal agent for E. I’d def stick with A.
After an accident that resulted in my having a punctured artery, the A&E consultant told me they can control bleeding and don't need a reversal agent - and, for me, they did! 
I've only ever taken edoxaban and have no problems, don't bleed excessively if I cut myself or after blood taken.
Same as Dudtbin for me - no issues with Edoxaban + certainly don’t bleed or bruise as much as when I was on Ticagrelor + Aspirin.
I am also on Edoxeban and have had no issues with it.
I too am on edoxeaban and feel far better than with Apax with the side effects ........
Glad you feel better. Can I ask what side effects you got with Apixaban.
Joint pain and sick feeling all the time .
if it works well for you why change ?
Here's an article that explains the background to this switching decision ...
pharmaceutical-journal.com/...
Knowledge is power, as someone somewhere once said.
We are all striving for "informed choice" in our medical treatment.
Thank you that article just confirms really what I thought, it all down to cost. I certainly agree knowledge is power.
I've been on Edoxaban since December 2019. No issues whatever and I've had two tooth extractions in that time.
I'm on edoxaban and asked my doctor about effects of it and he said they all do the same job equally.
I switched from rivaroxaban to apixaban two weeks ago as I'd read that the latter was rather better and safer all round. I think the evidence isn't as sound as the study I read suggested, however, having read more deeply, but my GP was happy for me to change.
He did try to convince me that edoxaban was the equal of apixaban, and I tend to believe him. Certainly, I wasn't able to find any worthwhile evidence to the contrary, so your findings are different. Do you have a link? In the end, though, as I say, I changed to apixaban and he was happy despite the increased cost.
Steve
My arguements for staying on apixaban are
1) apixaban is only DOAC with an antidote
2) edoxaban is not so good for your kidneys
3) apixaban prescribed by consultant cardiologist so why should gp/pharmacist overrule the consultant (unless they agree)
4) GPs are being paid to swap everyone to edoxaban
Ask your pharmacy for the new, now available generic apixaban.
someone mentioned yesterday that patent has run out on Apixaban so generic should be much cheaper. That might be a good alternative for those of us on Apixaban and reluctant to change.
I thought Apixaban is the generic of Elequis.
Eliquis was the only manufacturer of apixaban until they lost the licence/patent. Teva and Sandoz are now making it. I got mine (sandoz) this week for the first time.
Bristol Myers Squibb was the manufacturer of Eliquis which is the brand name of Apixaban. All drugs have generic names with the last few letters denoting their "class" ie "ban" ,"lol " and brand names that often bear no relation ie Eliquis, Xarelto, Lixiana for the 3 "bans".
see Cat04 answer.
I changed about 3 years ago, my GP said there had been a problem with compliance & also the length of time in between the 2 doses, I agreed I would change ,I haven’t had any problems. I certainly don’t have any additional problems with bleeding, so what if it’s cheaper we should all be trying to economise
Cost, I'm sure, they tried this one with mum and I wouldn't agree to it
Just thought I would add to this. My brother was diagnosed yesterday with afib by a consultant at the hospital following a stroke. He was prescribed Edoxaban until I intervened and asked if he could have Apixaban like me. We were told, yes, the hospital could provide the initial 2 months of Apixaban but my brother would have to argue this one out with the GP for further treatment as Apixaban was more expensive and it was a matter of cost.... confirmed, consultant's words!
yes it’s a matter of cost when two drugs do the same job equally of course they want you to take the cheaper one the NHS is struggling for cash
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