paxlovid with reduced elequis to 2.5mg twice a day

[execz1]

has any one when taken Paxlovid for covid infection continued to use Eliquis at reduced dose to 2.5mg . If so please can you share your experience with such situation.

thank you all

[mjames1]

Great question, as so many of the afib and heart drugs we take may be contraindicated, or need a reduced dose while taking Paxlovid.

Thinners like Eliquis are just one example. Flecainide is another which is completely contraindicated.

Reducing Eliquis, 5mg twice a day to 2.5 mg, twice a day, seems to be the accepted protocol per the University of Liverpool's covid interaction drug checker and also found at Michigan Medicine's Covid drug checker. In addition to their website , the university of Liverpool has an iPhone app dedicated to these reactions.

I've also read the same on forums like these where a number of ep's reduced the dose to 2.5mg, twice a day, because of Paxlovid interactions.

Depending on a number of variables, they may want to reduce your dose of Eliquis, or they may want you to use an alternate treatment other than Paxlovid, or no treatment at all.

Here in the United States, Remdesivir Infusions are selectively offered where Paxlovid is contraindicated. Next in line of efficacy is the oral drug Molnupiravir.

Keep in mind these recommendations change frequently, based on ongoing research, and what strains of the virus are currently circulating, as well as geographic availability. The recommendations I have highlighted are from the CDC in the United States.

Of course always check with your doctor in all matters of medication changes.

Jim

[execz1 in reply to mjames1]

Thank you Jim for your quick and very informative reply. several weeks ago I stopped Flecainide after less than two weeks of use due to pauses that never had previously to taking Flecainide. So the only med that needed to be reduced was Eliquis and no other contraindicated drug. the choice was way less effective drug to Paxlovid or Paxlovid with tolerable risk. Since I am 82 with extensively scared right lung my risk with covid was much higher than potential increased eliquis concentration. Unfortunately people like me with Afib and respiratory issues had enough to deal with before covid so one more health challenge to deal with .

[mjames1 in reply to execz1]

It sounds like you made the right choice. In case you missed it, I've just expanded my original post to include some of the other options, including probably the less effective option, you alluded to.

About a month ago I was dealing with the same question after being exposed to Covid. Fortunately, I ended up not getting it. However, I had already lined up an infusion center for Remdesivir, just in case.

My problem was Flecainide, which while I was not then taking on a daily basis , is my PIP rescue drug. So if I had taken the Paxlovid, I would not have been able to take the Flecainide should I have gone into a fib during that time period. Alternatively, I could've taken Paxlovid and just rode out any potential afib episodes without PIP Flecainide.

Jim

[execz1 in reply to mjames1]

Thanks again.

Well I have today and tomorrow to take my remaining doses of Paxlovid . I believe that my initial covid symptoms like fever, coughing, and aches and pains have stopped after 5 doses out of total of 10 . currently as of early morning I am struggling as usual with an AFIB episode that feels other episodes before Paxlovid , however due to current situation I am more anxious.

So covid was tested positive at the ER on Tuesday/Wednesday. So after all testing the ER doctor suggested Paxlovid at which time I told him that due afib medications I can’t take paxlovide but the alternative is recommended. To my surprise he wasn’t aware of any alternative and he said he will check the data base and he wrote a prescription for the alternative. After discharge that morning I read about the alternative and found it to be very inferior and arranged for Paxlovid with proper protocol.

I hope you don’t mind the lengthy writeup , but I thought the ER experience shows people need to be proactive in their heathcare win or lose.

[mjames1 in reply to execz1]

Yes, unfortunately a lot of the doctors are not up-to-date on current Covid tx options.

Most seem to know about Paxlovid and the inferior Molnupiravir, but I had to do a lot of digging to find a Remdesivir infusion center, which is currently the next best choice to Paxlovid.

Unfortunately, we do have to be proactive and do independent research in all important medical decisions, or frankly we may not receiving the best care.

Hopefully the Paxlovid will take care of your Covid quickly and your afib episode will resolve.

Jim

[AnneRB]

here in California it was said like a math problem. Paxlovid and Eliquis 2.5. I had to take Paxlovid twice ( 2 rounds ) bc of rebound. No ill effects from that but my Blood O2 went to 76 bc of Covid so that was the most important to address.

[execz1 in reply to AnneRB]

Thank you AnneRB,

Did you experience Oxygen decline in the initial infection or during the rebound? Did you have normal lung function prior the Covid infection and if not and you recovered were left with respiratory scaring or other complications ?

I hope you have recovered completely and was restored to your normal activities.

[AnneRB]

rebound was a nothing just a little sniffle but tested positive. O2 level is usually 95 % or higher. The first night of infection I had a fever and took Paxlovid. Fever and symptoms were gone by morning. The thing is the night was god awful and my Apple Watch said my O 2 levels were at 76. I still am meeting w the cardiologist about tachycardia since Covid but no recurrence of paroxysmal a fib🤞🏼

[RVine3]

A few days ago I was given the choice between Paxlovid with 2.5 eliquis reduction...it was explained to me that with Paxlovid 2.5 eliquis retains its 5mg strength...He also gave me a choice of a less effective choice but one that has no adverse interactions with other medications so I opted for Lagevrio...it's 50% as effective but at least it's something and allows me to take my other medications which I feel I need...who knows?

[execz1 in reply to RVine3]

Hello RVine3,

I would have made the same choice if it was not for my preexisting respiratory condition that put me at higher risk of advancing to serious Covid outcome. So my priority was to fight Covid and deal with the other medications of which none paused high risk of interaction.

[RVine3 in reply to execz1]

That sounds like a good priority. Good luck with it.