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NHS SPS - Specialist Pharmacy Service - has published two papers about DOACs

Carew profile image
22 Replies

The NHS SPS - Specialist Pharmacy Service - has published two papers about DOACs. In case they are of interest:

Understanding direct oral anticoagulant (DOAC) interactions (Published 5 January 2024)

specialistpharmacyservice.c...

Managing interactions with direct oral anticoagulants (DOACs) (Published 5 January 2024)

specialistpharmacyservice.c...

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Carew
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CDreamer profile image
CDreamer

Lasted 13 hours so far.

Robfromwales profile image
Robfromwales

From those more conversant with the main accepted science to date - do these change any conventional wisdom on medicine management?

BobD profile image
BobDVolunteer in reply toRobfromwales

Sorry since we are apparently not allowed to view links anymore I couldn't possibly comment.

baba profile image
baba in reply toBobD

How do you, or I, know they haven't been approved by admin?

Carew profile image
Carew in reply toRobfromwales

The Understanding page shows the cytochromes associated with various DOACs. I could not tolerate Rivaroxaban and Apixaban and see that both are linked to CYP3A4 - have just got Edoxaban and that says:

Edoxaban is weakly metabolised by CYP3A4/5 and is a substrate of P-gp.

(Rather than "mainly".)

And I do have reason to wonder about CYP3A4 so am really quite happy to see that. Maybe it will be OK?

Carew profile image
Carew in reply toCarew

For info:

Rivaroxaban affected my eyesight - fine focus was impaired.

Apixaban affected my feet - a certain numbness. Started to improve when I (inadvertently) ran out. Still not fully resolved but definitely started to get better the moment I stopped taking it.

Entirely personal experiences and only added in case anyone is mildly curious.

CDreamer profile image
CDreamer in reply toRobfromwales

In my view - yes. It’s based on research into how different drugs are metabolized.

It also explains why some people have side effects from a/c whilst others don’t and what other compounds interact.

momist profile image
momist

Thanks Carew. I think I'd better stop using Gingko Biloba (I take Apixaban).

Robfromwales profile image
Robfromwales

thanks for replies.

Robfromwales profile image
Robfromwales

On your point Bob - are admin or anyone saying links to presumably appropriate science based research shouldn’t be allowed.

CDreamer profile image
CDreamer in reply toRobfromwales

That’s what we are attempting to clarify but I guess it depends on your definition of appropriate science based research?

TracyAdmin profile image
TracyAdminPartner

Hello, just to confirm, external links are allowed to be posted, however, please check with the Admin team in advance to posting.

Admin are here to protect misleading information being shared with the wider audience on all our Forums - therefore, just as before, it is important we check the validity of the source and facts for the benefit of others. Having checked these links in this post today, I can confirm they have been given consent.

I thank everyone for their understanding and hope you understand the reasons behind our requests.

Kind regards

TracyAdmin

CDreamer profile image
CDreamer in reply toTracyAdmin

I don’t think anyone is going to do that Tracy because of all of the reasons given in recent threads.

When you will not disclose criteria for judgement of what is or not ‘valid’ it smacks of censorship and a closing down of subjects that you think shouldn’t be discussed but are of interest to some members.

You took 2 of my links down but not this one - please explain the difference? Is anything from NHS site ok but not from eg:- Mayo Clinic?

Would Dr Gupta’s excellent video explanation on Nattokinase a ‘valid’ link?

When FJ’s link by Prof Schilling gets removed and this one doesn’t we are naturally upset and extremely worried about your aims.

Is the blanket ban of insisting on screening to ease your workload or to gag discussions on controversial but very valid subjects - such as academic enquiry on how the x5 stroke risk figure came into being?

An explanation of the purpose of this very recent CHANGE in forum ‘guidelines’ would be welcome.

Best wishes

Finvola profile image
Finvola in reply toCDreamer

When something doesn't make logical sense to me and seems to be a make-work for all concerned, I ask myself 'who benefits?' Corporate agreements? Vested interests?

baba profile image
baba in reply toTracyAdmin

What is the quickest way to get link approvals TraceyAdmin, phone, email, private message? and how long will we wait for a reply.

TracyAdmin profile image
TracyAdminPartner in reply tobaba

Please contact either Katrina or myself via the 'Chat' function, we monitor the Forums on a daily basis (Monday-Friday) we will respond at our earliest convenience.

Carew profile image
Carew in reply toTracyAdmin

I suggested using Contact Us because that avoids the need to decide which of you to contact. Effectively, it sends PM to all admins/moderators.

Is that a bad idea?

TracyAdmin profile image
TracyAdminPartner in reply toCarew

'Contact us' or 'Chat' to either Katrina or I is the best form of contact.

Finvola profile image
Finvola

Thank you for the links, Carew - this is the type of good information which helps to keep us safe. I have saved and printed the interactions sheet - some of which my cardiologist warned me about. He also told me to avoid anything with St John's Wort in it (I take Apixaban).

Thomas45 profile image
Thomas45

My personal experience of Rivaroxaban was that it was the straw that broke the camel's back. My body reacted to it with an auto-immune condition, that was Polymyalgia Rheumatica, which took nearly four yeave to leave my body, needing a very, very, slowly reducing dose of prednisolone.I then had a choice, to try another DOAC or go back to Warfarin. I bought my own INR meter and went back to Warfarin. My INR soon stabilised.

baba profile image
baba

Thank you Carew, you seem to have more information than I have, I've not seen any list of who can approve links just "Admin".

Carew profile image
Carew in reply tobaba

These are what I am going by:

Please remember to send a message to me [Katrina-Admin] or TracyAdmin so that we may review the link before posting on the forum.

healthunlocked.com/afassoci...

Please note, if links are posted without Admin consent, they will be removed. If you have any questions or would like to contact one of the Admin team, please feel free to contact: info@afa.org.uk

healthunlocked.com/afassoci...

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