Low dose <5mg eliquis

[Bobsterguy]

I am taking Eliquis 5 mg twice a day. I get some significant bruising. I am also taking ibrutinib 140 mg which is lowest dose...blood counts are good. I was also diagnosed with afib. I'm wondering if anyone is taking less than 5 mg Eliquis twice daily and if that works? I've talked with a couple friends and they think a half dose of Eliquis may still work okay. I wonder what your thoughts are? And if it might be acceptable to take one 5 mg Eliquis tablet daily instead of two? Or would cutting a 5mg tablet in half and taking half dose 2x per day work? A friend claims it still works. Others say no. Does anyone have any experience or opinions? I want to reduce my present bruising & considerably fatigue. Sometimes can sleep 16hrs daily. MD also cut my past 20mg rosuvastatin in half. Helped a bit. Thanks in advance for any feedback re lower dose Eliquis. Bob

[Buzby62]

My opinion is not to listen to anyone’s opinion except your prescribing medic.

Eliquis or Apixaban as we call it is a 12 hourly medication whatever dose you are prescribed. I have read that it can be reduced for over 80s with under a certain body weight but that’s for the medics to decide.

Link to Apixaban info

api.heartrhythmalliance.org...

Best wishes

[Bobsterguy in reply to Buzby62]

Tx

[CDreamer]

Fraility, old age and very low body mass are the only reasons to reduce your dosage - which should never be considered without the direction of your doctor. If you are concerned about the drugs you are taking and their affects please talk to your doctors and ensure that all prescribing specialists are aware of your other treatments - never assume that because they have your notes they have read them or will remember.

[Bobsterguy in reply to CDreamer]

Thanks...

[Gumbie_Cat]

I agree with the other comments. I was recently in hospital with an oesophageal bleed, following an attack of vertigo and sickness.

One younger GI doctor mentioned that I might still be protected enough by taking the half dose, but this was contradicted by the medical team. I have a family history of stroke and permanent AFib - so stroke prevention has to win out for me. The advice on discharge was to go back to my normal dosage - a relief for me, despite the bleeding.

For those who have two out of the following three conditions, a half dose is used - over 80, under 60kg, kidney problems. This is always a balance of risk equation. Also, those on that half dose would take 2 x 2.5mg - this is a drug designed to be taken twice a day.

[wilsond]

Friends might be well-meaning but unless they also happen to be Electrophysiologists or Cardiologists,( and even then dodgy without access to your medical notes) and are unqualified to advise. Please speak to your prescriber for safety. Anticoagulants are given for good reason .

After the age of 75 and if underweight,the dose can be halved. Otherwise Apixaban is 5mg x 2 daily,for life

For Dvt care ,Anticoagulants are halved( ie my husband is on 2.5mg Apixaban x 2 daily fir a period.

I experience bruising etc. I find Arnica cream very good.

I'd rather bruise than have a stroke!

[Bobsterguy in reply to wilsond]

Tx

[Desanthony]

In answer to your question - I echo all the above. You need to discuss this with your prescribing Doctor.

I was changed to half dose on agreement between my knee surgeon and cardiologist and EP for a month following my Total Knee Replacement back in 2019. The hospital forgot to give me the medicaiton when I was discharged late on a Saturday morning so until they could get my medication to me by post I had to cut tablets in half as my pharmacy didn't have the lower dose pills either. What a fiddly job but we managed it. Had no problems but this is not a thing to do on your own. Please consult with the prescribing Doc.

[Bobsterguy in reply to Desanthony]

How long were you on half dose I assume you took 2x daily? What was the reason they went to half dose for you? Did you have any issues on half dose? Yes I will review with all my MDs . Just want to learn about others experiences. Thanks much.

[Desanthony in reply to Bobsterguy]

I was on half dose for 1 month following my total knee replacement operation. This was to alleviate bruising and swelling after the operation to enable me to do all my exercises from the off - that definitely paid off as I can now even kneel down on that knee even though they told me I never would be able to do that and I have 130 (ish) degrees of movement - which is amazing with the artificial knee. I had no problems with going on the lower dose - it was half dose twice a day. My orthopaedic surgeon and Cardiologist discussed this before hand - as I say the worst part for me was not being given the lower dose pills when I left hospital on the Saturday morning as the local pharmacist didn't have them so we had to cut the pills I had in half - which was fiddly and caused a little wastage. Thankfully the hospital managed to get the lower dose pills out to me by mail on the Monday afternoon. I had no problem with this but it was only for a short time. As for bruising I didn't have any more than any one else who had the operation the same day as me - this came out about 10 days later and swelling and inflammation around the area was about the same as everyone else too - we all met up at our gym and physio sessions afterwards so obviously compared notes. I had no issues with the half dose but I was in NSR before during and after the procedure having had my second cardioversion about 6 weeks prior to the operation. I was normally in persistent AF but cardioversions worked well for me. My wound took just as long as others my age to heal too. I never did bleed much when injusred - handy for me in my job and always healed quick. I have not noticed my anticoagulants have changed this very much and have been on them since 2017 I do notice I bruise more easily - but that's the same for every one my age - I have now just turned 80 and was nearly 76 when I had my knee replacement.

[Bobsterguy in reply to Desanthony]

Thanks very much. Good luck. I turn 80 in May. Milestone. 😁😁👍👍 Have a good summer

[ozziebob]

As others have indicated, this question is not one for us "amateurs". Best seek professional advice.

However your question does interest me for personal reasons.

In England you need to meet 2 of 3 criteria for low dose apixaban (eliquis). Above 80 years old, below 60kg weight, and/or a compromised renal system.

The following research concludes half dose apixaban gives a higher stroke risk ...

"Effectiveness and safety of low-dose versus standard-dose rivaroxaban and apixaban in patients with atrial fibrillation" ...

ncbi.nlm.nih.gov/pmc/articl...

Good luck.

However, my Reply comes with the following advised "Warning from Admin: If anyone has any questions regarding the article and how it may apply to them to please speak with their doctor or healthcare professional for advice"

[Cumbremar5]

I have similar problem with bruising mainly on shins area and have been biting a 5mg tablet and taking twice a day which I feel protects you better than taking one 5mg tablet once a day. I ran that past a friend who is a pharmacist and he agrees with me. It does work with less bruising and heavy bleeding also healing wounds and scratches normally. But that is meOn the patients information sheet they recommend if you are over 80 and under 60g 2.5 mg twice a day. My Spanish gp won't prescribe the lower dose but not confident with spanish doctors over here in the Spanish health system.

Anne

[Bobsterguy in reply to Cumbremar5]

Good feed back. Tx. Ill review with my MDs . Tx. Bob

[Auriculaire]

Half dose Apixaban does work but less well for ischaemic stroke than the full dose. This was shown in the clinical trials. Same for the 110 mg dose of Pradaxa. So in taking a lower dose you would be upping your risk for stroke. I would not think it worth it to avoid bruising. Are you sure the fatigue is caused by the Apixaban? Are you on any other meds for the afib that might cause fatigue?

[Bobsterguy in reply to Auriculaire]

Not sure what causes my fatigue. On 12 pills daily which they all want. Thanks for your good feedback. Will discuss all options with my MDs . Tx Bob

[Auriculaire in reply to Bobsterguy]

Polypharmacy can cause people to feel tired and unwell. There is no research at all on the effect of taking multiple different drugs. You get info on interactions of two different drugs but once you are taking more than 3 different things doctors just don't have a clue. There have been trials to take old people off some of the drugs that probably are not really benefitting them - result they feel better.

[Bobsterguy in reply to Auriculaire]

Yes I'm trying to reduce number Rx but not much encouragement from my MDs. Tx for input. I'll keep trying. 😁

[Bobsterguy in reply to Auriculaire]

Tx much. Will review all with my MDs. 👍

[Bobsterguy]

Thanks to all on this wonderful discussion group. Renews my faith in all good people. Thanks

[wilsond in reply to Bobsterguy]

You're welcome Bobsterguy x

[Hdev]

I am a 77 yr old woman,,,I’ve taken the same dose as you past 2 years,having afib 8 years at present,,,had been on warfarin prior but MD feels Eliquis is much safer and works better,,,I’ve had no side effects from Eliquis that I am aware of,,,I do know NOT to take other drugs that might add to “thinning”the blood,,,such as aspirin,,,since there is no testing yourself to check your INR regularly,you must rely on a standard dose prescribed by your MD so that Eliquis is working for you appropriately to prevent a clot that might cause a stroke,,,You need to follow your MD’s direction as to dosage exactly,,,to mess around on your own cutting or increasing the dosage is like playing with fire,,,if you don’t have proper coverage to prevent a blood clot and stroke,you could find yourself deceased or badly damaged from a massive stroke,,,scare you? It should,,,,it’s not the afib that does the damage,,,it’s the possible ensuing stroke that you need to prevent,,,please follow doctors orders ONLY. This is not the time to self medicate!Any bruising questions should be directed to the doctor, ,,, Be well!

[Bobsterguy in reply to Hdev]

Tx much

[djmnet]

With my EP's approval, I cut back my evening dose to half a tablet after experiencing severe nosebleeds last year. It made quite a difference in the bruising issues and for that I'm thankful. I take 5mg in the morning and half a tab at night.

[Bobsterguy in reply to djmnet]

Tx

[marcyh]

You say your blood counts are okay, I would assume your platelets have been checked then...

[Bobsterguy in reply to marcyh]

Tx. Yes platelets are at very low end of normal range

[marcyh in reply to Bobsterguy]

I would ask if that might have something to do with the bruising.