Blood thinner options...: Diagnosed... - Atrial Fibrillati...

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Blood thinner options...

sunlovah profile image
46 Replies

Diagnosed earlier this year.

Working my way through due to uncomfortable physical side effects.... (Done edoxaban, rivaroxaban) on 5mg 2 x daily now. Does it follow that Apixaban if twice daily , is a lower dose therefore, more gentle on your stomach and your system?

Wondering if there is ever truly a side effect thinner that will be side effect free for me, I just want to feel 'normal ' again.

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sunlovah profile image
sunlovah
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46 Replies
Buffafly profile image
Buffafly

Nothing to do with frequency of doses, it’s just the best one for stomach issues. Rivaroxaban horrible for me.

sunlovah profile image
sunlovah in reply toBuffafly

So is each apixaban tablet a lower dose, but split up over 24 hours?...therefore kinder. as opposed to a 24 hour single tablet?

BobD profile image
BobDVolunteer in reply tosunlovah

Diffeferent type of chemicals, so different way to take it.

10gingercats profile image
10gingercats in reply tosunlovah

2.5mgx 2 daily of Apixaban if you are over 80....usually. Otherwise, 5mg x 2 daily if under 80.and.....check with your GP for dosage...could be different for you but not likely.

sunlovah profile image
sunlovah in reply to10gingercats

Thanls.Be nice if I could be on 2.5, but not over 80.

pusillanimous profile image
pusillanimous in reply tosunlovah

Speak to your doctor, but I think if you have a low body weight, then the lower dose of Apixaban is recommended.

Sailndive profile image
Sailndive in reply to10gingercats

It horribly expensive. Even with insurance almost $200.00/ month. I stopped it after 2 years because the 10.00/ month “coupon” ran out. There is no generic. The company is just ripping people off.

baba profile image
baba in reply toSailndive

There are generics now

Madscientist16 profile image
Madscientist16 in reply tobaba

Not in the US. Maker of Eliquis went to court with new patents and generic availability is now November 21, 2026.

pusillanimous profile image
pusillanimous in reply toMadscientist16

I read they did that with Xarelto too, in the US, although the generic of that drug is available in Africa but it has a different name (slight variation) it's packing and appearance is identical to the original and it appears to be made by the same drug company.

Desanthony profile image
Desanthony

I shall be 80 in a couple of months I am due my blood tests in October I must remember to mention this - I did know but had forgotten.

Buffafly profile image
Buffafly in reply toDesanthony

You have to be under 60kg as well.

wwatson280283 profile image
wwatson280283

Hi Sunlovah, can you advise what tummy problems/ symptoms you have and believe are caused by thinners?I was diagnosed with gastritis a diverticulosis back in 2021. In 2022 I was prescribed apixiban as my AF originally diagnosed in 2016 started getting worse. I am now not so sure that my own tummy troubles which have become worse since January this year are caused by gastritis diverticulosis or indeed my prescribed apixiban.

sunlovah profile image
sunlovah in reply towwatson280283

Twinges, Bloating,achey inside from waist up, sometimes going around the back under ribs, back ache. Insides feel like jelly.. if that makes sense. Before I take meds and as they're wearing off I feel normal. Then about an hour after taking it starts.

Been in NSR since May after CV. First episode, brought on by shingles.

sunlovah profile image
sunlovah in reply towwatson280283

Bowel movements normal, but lost appetite so not as usual proportions! Lost 8 kg in 5 months (every cloud) but that was mainly I believe, caused by omaprazole-severe abdominal pain after eating every time almost. I was put on it under the 'one size fits all' regime, even though I'd never had an acid problem. I've stopped it myself, 4 weeks ago. Wondering if my stomach is still re regulating my digestive acid, I understand that this can take weeks/ months..........does anyone know???

Cabinessence profile image
Cabinessence in reply tosunlovah

On 2 x 5mg Apixaban and no symptoms whatsoever. Yet. Been on it since last November.

Was on omaprazole for a short while I was also on aspirin, but once again with no symptoms. But got taken off it once they stopped the aspirin after I had an ablation 6 weeks ago.

wwatson280283 profile image
wwatson280283 in reply tosunlovah

I too was put on omeprazole and then esomemprazole. I no longer take it as didn't think my symptoms were anything to do with reflux and also heard bad things about PPI'S

Silvasava profile image
Silvasava

Been on Edoxaban for nearly 3 years after a stroke. Dose was lowered in January this year as lost weight due to being hospitalised with a bout of flu. I do have more frequent motions but no other effects. Weight gone back up now, just hovering on 60kg so may increase again as hoping to see cardiologist next month.

Jill13 profile image
Jill13

Hi sunlovah

I wonder the same about anticoagulants. I have tried three. Now on Eliquis.

My problem is not digestion issues but rashes. Now take an antihistamine every day to help with this.

Wish we didn’t have to take them but know they are necessary. I am in permanent AF so know I am on them for life. I am 83 now but AF began about 7 years ago

wilsond profile image
wilsond

I was given Apixaban because of long standing IBS and have had no worsening of IBS or other gastric issues. Worth trying

sunlovah profile image
sunlovah in reply towilsond

Thanks

I'm on that now, trying for a second time.

Blearyeyed profile image
Blearyeyed

Is it stomach pain , cramping, indigestion or changes in bowel that you are being effected by ?Different gastrointestinal side effects often need different methods to help ease them.

I have various other conditions including exocrine pancreatic enzymes deficiency, severe IBS - C , gastritis, intestinal bloating and gut dysmotility so I do need to be careful about how and when I take medications.

Just wondering are you taking the medication with plenty of water and some food?

This helps for me with all medications that cause stomach side effects.

I usually take my meds with a few spoons of yoghurt with a little honey or at the same time as my vitamins after a light meal.

I make sure I take my medications and have time to sit and relax for half an hour afterwards because often the stomach side effects can be worse if you are very active straight after taking any medication.

Drinking cool water throughout the day and during eating also helps reduce my stomach symptoms, from both my health issues and any medication side effects as well.

Unfortunately, we often don't feel 100% of the "Old Normal" after developing a health problem and starting medication and need to find ways to adjust to the " New Normal".

Making little changes that reduce the side effects or illness symptoms to their minimum really helps .

Working out which is the right brand of medication and dose for you and the best times to take it can make a big difference to that .

Hope things improve soon , Bee

sunlovah profile image
sunlovah in reply toBlearyeyed

Thanks for your comments. Ive taken before. Middle and after food. Apixaban with breakfast and in the evening. Wash down with a glass of water which I have with a meal as well. Always drinking water etc during the day. I feel that it's the nature of the drug and what it does which has an effect on me. These side effects vary and change during the day over hours of time.

For some strange reason, if I take meds approx 2 hours before bed, they don't seem to bother me at night, maybe because I'm asleep.....it is wearing every day.

Blearyeyed profile image
Blearyeyed in reply tosunlovah

I found I can't take medications that close to bedtime but usually try to have them all done 3-4 hours before if possible.Although they don't seem to effect me at night the effect was bigger on my stomach in the morning, especially because I have a slow gastrointestinal system. I know a number of people with sensitive stomachs and gastric problems whom need to use this method and be careful about having any of their medications still travelling through the body during the night.

Night time stomach acid and gastric reflux may not wake you up but it can be causing effects which produce symptoms during the day.

The side effects can often feel worse in line with your activity , your digestion and your body clock , which is why the symptoms can be the same but the triggers for them can vary a lot between people with different individual health profiles.

sunlovah profile image
sunlovah in reply toBlearyeyed

Thank you for your comments. I understand what you say I take apixaban as advised 12 hours apart, means evenings for the second on.

Peacefulneedshelp profile image
Peacefulneedshelp in reply toBlearyeyed

You mention pancreatic enzyme indefiencency. Do you take enzymes to help digest food? We stop making enough after the age of 25

Blearyeyed profile image
Blearyeyed in reply toPeacefulneedshelp

I have prescribed enzyme medications it is a chronic condition that I was diagnosed with. Enzyme Deficiency conditions are quite complex and aren't usually just because of changes that occur from production at particular ages.

Peacefulneedshelp profile image
Peacefulneedshelp in reply toBlearyeyed

Right, but for all us enzyme production can be age related

Blearyeyed profile image
Blearyeyed in reply toPeacefulneedshelp

Enzyme production does reduce naturally as we age but the amount made and released by the pancreas by a generally healthy person is still within ideal levels over time.There are various reasons for malabsorption of nutrients , broad spectrum enzyme insufficiency is generally not the common cause.

People can have specific enzyme problems causing intolerances to certain foods or reduction in the metabolism of lipids, sugars or certain proteins because of a dysfunction in production but this usually has a genetic link rather than just relating to age.

There are multifactorial causes for malabsorption.

Countrydweller2 profile image
Countrydweller2

I haven't felt well through each blood thinner and as my private cardiologist said, 'some people just have strokes, whether they take apixaban, xarelto......' He shrugged, and told me to continue with Xarelto even though they played hell with my legs and a friend had her second stroke while taking it.

Auriculaire profile image
Auriculaire

Most people here do fine on Apixaban. But for those who get side effects it is hard to regard it as one's friend. I look upon it as the pink poison I have to take. It gives me digestive issues like bloating ,reflux and diarrhoea and worsens my joint pain especially that from the squashed disc in my spine. I have tried Dabigatran- even worse gastric issues and probably the other "ban" anticoagulants would be no better so I am reluctant to try them - not sure if Edoxaban is prescribed here in France anyway.

Sailndive profile image
Sailndive in reply toAuriculaire

Dabitatran is a horrible drug. It causes nasty GI issues. I’ve only been taking it about 6 weeks. I did very well on Eliquis, but after the “coupon” for $10.00/ month expired it was $ 200.00/ month with insurance. Drug companies need to be held liable for what they do to patients.

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply toSailndive

Hi

I've never had gastro problems with PRADAXA. First 110mg x twice with triage, then transferred so local Dr changed dose to 150mg x twice. I was diagnosed with thyroid cancer. Research says folks with cancer should not take DOACS/NOACS.

As soon as I knew the upping of it I demanded lower dose.

All my life with reflux, gall bladder (disintegrated) in 2000, my bile drips all the time.

We pay nothing but a prescription fee which changed 1st August to 0 fee.

Anti-co-agulant is a choice.

Think it thru and do what your gut leadsyou to.

Even taking it is not 100% against forming a clot.

cheri JOY. 74. (NZ)

Ppiman profile image
Ppiman

I’m not sure most people have stomach side effects. It’s something that is sometimes reported here though. It might be that your stomach lining is very sensitive. The trouble with the whole gastric and intestinal tract is that it has such a massive blood supply system and that can mean “thinner” blood could cause some issue or other. As silly as it sounds, and excuse the indiscrete comparison, but it's one of the reason why haemorrhoids bleed so very easily.

It might be that you’ll need to take a PPI drug to protect the gastric mucosa and yet still allow for the very important anticoagulant? That’s not the best way forward since PPI drugs are not always entirely trouble free…

Life with arrhythmias is never easy.

Steve

Auriculaire profile image
Auriculaire in reply toPpiman

I have never thought about the possibility of the gastric issues some people can get on anticoagulants being due to the alteration in the blood supplying the gastro intestinal tract. Given it affects me all the way down to the bowel it makes more sense.

sunlovah profile image
sunlovah in reply toPpiman

Tried PPI was so bad, hours of abdominal pain sent me to A &E. Was put on them when I've never had an acid problem. I believe that they reduced my stomach acid too much. I don't know how long it can take a stomach to re regulate itself though....anyone help?

Ppiman profile image
Ppiman in reply tosunlovah

These things are so very individual owing, in part, to the mucosa of the intestines. The PPI was acting on an inflamed stomach, I guess, from what you've said. Maybe an older H2 antagonist such as ranitidine or even the original, cimetidine, might help as they reduce stomach acid much less.

Steve

sunlovah profile image
sunlovah in reply toPpiman

Had an endoscopy 2 weeks after A&E, all normal

Ppiman profile image
Ppiman in reply tosunlovah

Well, let's hope you find a resolution. This thread has given plenty to think about.

Liver enzymes have been mentioned, I see, in one of the posts. The way we metabolise drugs is sometimes different owing to genetic or other influences especially in the liver, sometimes potentiating the effects of drugs meaning a smaller dose is required, for example.

Steve

sunlovah profile image
sunlovah in reply toPpiman

From research and the really bad side effects of omaprazole. Which has eased a little since stopped...I suspect that I may have low stomach acid - Hypochlorydria. If that's the case, this would effect med effects negatively....yes?Back to GP again in a week, wish I could get some answers.

Ppiman profile image
Ppiman in reply tosunlovah

I’m not sure about low stomach acid pH affecting drugs as I take esomeprazole and luckily find no side effects much at all from my other tablets. The role of the acid in the stomach isn’t as clear as we might assume, I believe, and the scare stories about PPI drugs are likely heavily exaggerated. Well - I do hope so for my own sake.

I hope you find a resolution. I find heart problems a real worry and often wonder what the future holds.

Steve

MarkS profile image
MarkS

If you continue to have problems with the DOACs, you could always try warfarin. A lot of us get on very well with it and it is relatively benign in terms of side effects.

Ppiman profile image
Ppiman in reply toMarkS

I was wondering much the same as it's so well established and understood in comparison, but my friend (much older than I am) has always bruised incredibly on warfarin, whereas I (so far...) don't on apixaban.

Steve

sunlovah profile image
sunlovah in reply toMarkS

Was trying to avoid as all the monitoring . Might head that way....are there any potential long-term effects on the body

MarkS profile image
MarkS in reply tosunlovah

No long term effects on warfarin, which are unknown for the DOACs. You do need to keep your Vitamin K intake up and fairly steady. I take a Vit K2 capsule every day which evens out any fluctuations. It is worth buying a Coaguchek monitor if you do opt for warfarin, then it's easy-peasy.

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

I chose PRADAXA because twice a day. Also there is a lower dose of 110mg x twice. I take with water and fruit or juice.

We don't have apixaban offered in NZ.

I got on to the understanding that I had an accident on whereabouts on the dose and there is an antidote.

cheri JOY. 74. (NZ)

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