I had persistent AFIB for many years until I had an ablation procedure in 2022. It was successful and I have not had an AFIB episode in over a year. I check my sinus rhythm every day with my Kardia Mobile device and I am on 100Mg Flecainide per day. I am a 72-year-old man and very physically fit.
Because of my history with AFIB I am on Eliquis. A three-month refill costs me a $500 copay on my insurance policy. There are the usual risks of bleeding associated with blood thinners. Although my cardiologist wants me to stay on Eliquis, I am thinking about discontinuing it.
I would really appreciate any advice or input!
Written by
kurtgv
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I am 72 years of age. I was on Eliquis until my Cardioversion. My Electrophysiologist gave me clearance to go off Eliquis at my 6 month exam because I had been Afib free. I was taking the supplement Hawthorn Berry which could mimic Eliquis. I still take Magnesium, CoQ10 and Hawthorn Berry the past 2 years and have been Afib free.
I would take your cardiologists advice and stay on it. You could have little runs of AF during sleep, which would put you at risk. An ablation is for quality of life and is not a cure, so AF could return at any time.
Just bear in mind that you cannot undo a major stroke.
I am not aware of anticoagulants causing damage to the heart. Quite the contrary in fact.
Six monthly blood tests should be taken to check liver and kidney function. Any changes are picked up early and dosage adjusted accordingly.
My understanding of the reason we need to have tests for liver and kidney problems when taking DOAC anticoagulants is not because these drugs cause damage to the liver and kidneys but that because if the function of the liver and kidneys was to drop for other reasons the drugs would be cleared less efficiently .
We need reliable evidence of your claim soonest please. You have effectively worried me first thing in the morning, as if I didn't have enough other things to worry about. Not something I like. So I at least need to know where you found that information.
There is no evidence that successful ablation removes stroke risk so stop at your peril/risk. Sure you can always stop anticoagulants but you can never undo a stroke. For those who may not understand this, the changes to the inside surface of the atrium caused by the ablation itself can create eddy currents which could result in clots forming. I'm 15 years post successful ablation but will never stop warfarin .
Hi Bob. You're a great advert for a successful ablation. I'm coming out of my blanking period and off Amiodarone next month and if you listen to many on here, I can expect to go back into Afib almost as a certainty. It's just a matter of when. How old were you when you had your procedure, how long had you had it for and were you in persistent of Paroxysmal? Hope you don't mind me asking?
I was diagnosed in 2004 (paroxysmal) but probably had it for ten years before that. I had ablations in 2005, 2006 and 2008 since when no AF but atrial tachycardia arrived in 2017. Had ablation for that in 2019. Pacemaker fitted for 2nd degree block in 2022. The moral being if you have arrythmias you will probably get arrhythmias. lol 😁
I stopped after 12 months clear after ablation, I was 62 at the time, then had a TIA - couldn’t get back on it fast enough.
Hello Kurt and welcome to the forum. Your question has been raised many times and if you type “stopping anticoagulants” into the search box top right of this page, you will probably see a huge number of old posts, some of which end up in verbal punch ups! There are a number of reasons why this happens and as you have only just joined the forum, it might be helpful if I share a bit of background information. I think this forum was first formed in the UK around 15 years ago and even now, the majority of members still live in the UK. However, like with many good things, a lot of work has been done to extend the membership into the US, Canada, Europe and Australasia. Whilst this is good in so many different ways, it does sometimes bring with it a number of different views and interestingly, your question touches on reasons why there can be such a wide divergence of opinion.
The risks associated with AF are the same the World over, as are the risks associated with taking OR NOT taking anticoagulants. What is not the same the World over is the way different countries provide healthcare for their respective populations and this is probably why there can be differing views expressed. I’m not medically trained, nor am I connected with the AF Association but I am a fairly regular contributor and I think it’s fair to say that not everyone always agrees with me but like so many others here, I do my best to help all members with AF.
I can only comment on UK health care because I have only lived in the UK.
The vast majority of UK public health care is provided by the State via the National Health Service (NHS). It’s funded by a form of tax which is based on a percentage of income from every wage earner in the country. As well as treatment, their contribution for prescriptions are fixed and in some cases free. Once someone has reached the national retirement age, they no longer contribute to the fund, nor are they required to pay for prescriptions.
Whilst this may sound great, it does come with some serious issues and drawbacks but picking up on your point, certainly all AF patients over retirement age do not pay for their medications or treatments. So although individuals may still have issues about risks or concerns regarding taking anticoagulants, they are not influenced by their ability to pay for them because they don’t and this may be a contributory factor to differences of opinions from countries like the US where, as I understand it, prescriptions are not free.
Personally, contrary to what some people may think, having worked in a hospital for several years, I am very well aware of the bleed risks associated with taking anticoagulants as I am about the increased risk of stroke associated with AF before or after a successful ablation. As far as I am aware, no close family members have suffered from internal bleeding, so having had successful ablations and with a CHADs score of no less than 2, there is no way I would stop taking my Apixaban (Eliquis), even if I had to pay for it.
Hi, I think there was a post on here a while back and the person had found that ordering Eliquis etc via web from Canada was much cheaper than in USA. Might be worth looking at.
I was told after my first episode of AF that it was anti-coagulants for life now. I think that the way. There isn't conclusive evidence, I gather, that it is the AF in and of itself that leads to the clotting in the atrial appendage (the clots that can lead to a stroke), but its shape and perhaps other cardiac aspects.
The cost for you is horrendous. Thank goodness for all its many current failings, we don't have that terrible burden to bear thanks to our NHS. Are all the DOAC drugs the same price as they are all similar. Apixaban and edoxaban are cheaper over here.
You might investigate switching to the popular and effective Warfarin. The cost is much, much, much lower, but........it is not as convenient as it requires frequent INR testing to optimize the Warfarin dose. I'm sure the many Warfarin users on this forum could give you helpful advice to help lower the financial burden.
Was about to suggest that Jim but not sure how US system works or costs for INR tests or whether owning a coaguchek machine and having to buy test strips would put costs up more than a DOAC ( e.g apixaban or similar)
I get 90 day supply of Apixaban, the generic for Eliquis from Canada Pharmacy Online for $369. It would save you a few bucks, anyway. Apixiban is not available in U.S. thanks to big pharma. canadapharmacyonline.com/
Eliquis is the branded name of Apixaban. In UK we will always use the name of the drug rather than the Brand. There are many manufacturers who produce generic Apixaban but in US there is only the branded name available so that is what US members tend to use.
Torches, lifts, and loos. Boots (the chemist) and boots (car trunk) and boots (soccer shoes). Near side and off side wings. Happy Christmas! (instead of Merry!)
'Pudding': Any desert. "Wot's for puds?"
As you probably gathered, I have several British friends. We delight in comparing languages.
Spent a bit of time in US so I speak a bit of Yank myself - rain gear, chips (crisps), ‘stuff’, Rest rooms but I NEVER was able to get a drink without ice - no matter HOW hard I insisted - do you know the magic words for ‘no ice in my drink please’?
Now I even struggle in UK to get a drink with no ice - not one of your better customs and cold drinks never good for AF’ears!
I was amazed when a bunch of US divers I was with didn’t understand me when I said fortnight, nor when we ran into a boot sale.
Sláinte mhaith (Irish for Cheers).
We are 4 some may say 5 countries speaking 4 languages and many dialects - which often have their own words. I can only speak a small amount of old fashioned Scouse myself and when I go home to Liverpool often need my nephew to interpret.
Seemingly the scars that are left post ablation can contribute to clot formation. So do your research before you do this. No idea where I got that information but it's definitely in my brain. Try google scholar for research
It probably won’t happen in my lifetime, but in the US President Biden has proposed limiting the cost of 10 most expensive ( to Medicare) prescription drugs.
I, too, pay ~$500 for a 90 day supply of Eliquis. The outlay by Medicare for Eliquis is over $16,000,000,000 per year. That’s over $5,000 per year for each Medicare patient taking it.
Eliquis is by far the most expensive drug in terms of Medicare spending. Bristol Meyers Squib and Pfizer have great lobbyists, and billions to spend on keeping things as is- so we’ll see how it goes….
May I ask is the $500 with Medicare or another health insurance program ? If Medicare, is there a supplemental insurance plan available that would defray the cost ?
I had my ablation on May 18, 2023, 90 day followup, doc said ok to get off Eliquis, have been NSR with occasion Kardia checks. I take multi vitamins, walk, excessive, healthy 79 years...
I had stopped anticoagulants for about 6 months before the TIA, my EP was VERY reluctant and stressed I needed to go back on them at 65 simply for being female = 1 & being 65 🤷♂️. AF did return so I was very glad I was back on them before it returned.
They do not not damage liver or kidneys but some people may not be considered suitable if there is any existing impairment. I am well monitored & have no concerns & I take other much stronger meds with higher risks for damage, where are you getting your information from?
Thank you for sharing your message with the members of the Forum. The Patient Services team strongly discourage discontinuation of any prescribed medication without prior consent of your doctor. Eliquis is a vital medication in protecting and lowering your risk of experiencing an AF related stroke. Please contact your doctor at your earliest convenience to discuss.
High risk strategy which is not recognised in the UK. Surely any Doctor who sanctions using any anticoagulant as a PiP in advance of the findings from this major trial almost underway in the US, should be immediately struck off………
I have been reading about anticoagulant as a PIP since 2014. It appears that most agree that this sort of treatment is not for everyone and needs to be tailored to certain individuals. Many doing studies cannot agree on how long of an AF event would require the use of the anti-coagulant along with at what dose and for how long after the AFib event the anti-coagulant should be taken. Many EP's agree that with the high cost of these meds, and the fact that MANY AF patients who should be taking these drugs do not because of lack of insurance/cost, that taking the drug as a PIP would be better than NOT TAKING THE DRUG AT ALL. If this method ends up saving lives, isn't that all that matters?
I think we can all understand the financially based reasons for the dilemma in the US but those reasons do not apply here in the UK. Our concerns are that those in the UK who are reluctant to take them for other reasons, could be tempted to follow this advice and that would undoubtedly COST lives here. There is a tendency for some American members to claim that we ignore the increased risk of internal bleeding which of course is wrong and this is why there is always a strong reaction from UK members every time the issue is raised. Although not so frequently now, some members from the States, have actively encouraged Brits, with fears about internal bleeds, to pursue an anticoagulant PiP regime which although is not available, is something they could do without the support of their Doctors. However, I appreciate that your comments were directed to a fellow American, so perhaps I should not have said that American Doctors advocating anticoagulants as a PiP should be struck off because I guess they are not responsible for cost issues which apply in your Country.
Thanks, FlapJack. Here in the US, we are just doing the best we can with a healthcare system that has been hijacked from both the doctor and the patient for the sake of insurance companies, congressional special interest and hospital administrators all in the name of greed. Oh and let's not forget the pharmaceutical companies that sell the same drugs to other countries for 5 to 10x less than in the US because they can get away with because of all the reasons I just mentioned above.
Many many people have strokes and die or live severely impaired lives as a result. I am not sure what statistics are for people who die due to anti coagulants but I am not aware of any body who has succumbed whereas I do know several people who have had strokes. Anticoagulants are a nuisance due to bruising and excess bleeding but I would not consider for one moment giving them up.
Are you absolutely certain you can't get this cheaper through Medicare? If you have some other insurance, you should call Eliquis and see if you are eligible for their $10 copay card. The only reason to be paying full sticker is if you have absolutely no insurance, not even Medicare.
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