I wonder if any of you can advise me please on anticoagulants.
I have been on Apixaban for some years and recently when I have had my repeat prescription from the pharmacy the manufacturer of Apixaban has changed four times. With the last one I experienced light headedness and with all of them tiredness.
What has been your experience with this and can you recommend a better one?
Many thanks for your time.
Gloria
Apixaban info - according to NHS website (I have bolded and underlined):
"Other common side effects
These common side effects of apixaban happen in more than 1 in 100 people. There are things you can do to help cope with them:
Tiredness and lack of energy
Feeling dizzy or light-headed
A mild rash
Feeling sick (nausea)
If this advice does not help and any of these side effects bother you or do not go away, tell your doctor or pharmacist."
I don't use AC so can't tell you my experience.
No doubt, you plan to discuss with your doctor, which you should.
Good luck
Thank you very much for this information. I have spoken to my GP and they are going to try me on Edoxaban so fingers crossed.
been on Edoxaban for quite a while now problems so far 😀
Good morning Gloria - I've been on Edoxaban for years and have no noticeable side effects.Hope it's the same for you.
Tim
Same here 🙌
We are all different. I tried Apixaban (Eliquis) and did not get on with it at all . Rivaroxaban (Xarelto or iXorolo as it's called here in Africa) suits me better.
Hi Gloria
I asked my GP to put the make of drug I like to use on my prescription. That is Accord (in North Devon) which also goes under the name of Actavis or Almus. For my old pharmacy it used to be a big deal to get them, so I changed to the Boots pharmacy in my town and they have no problem whatsoever. Make a note of the make that made you feel tired and let your pharmacy know that you don't want that one again, tell them why.
Jean
Hi Jean.
Wheras Accord acquired Actavis in around 2017 and their Apixaban are likely to be the same (though I would expect them to drop any Actavis branding as time allows), Alums is a totally separate company from Accord and so their product is unlikely to be exactly the same as the Accord / Actavis one (it’s possible if there was some joint development agreement or licensing arrangement or similar).
In an Almus box I have Levothyroxine packaged in an Accord tablet strip. Been like that for a year or more now, so there must be some connection.
Jean
So for Almus Levo, Accord are the manufacturer, presumably through a licensing agreement (as detailed above as one possible exception). The PIL will state who the Marketing Authorisation Holder is and who the manufacturer is. This is product specific. I can find no record of Almus branded Apixaban in order to check manufacturer on the PIL. If you have a pack, you can check the PIL on the Almus Apixaban to see if it is manufactured by Accord.
I know nothing at all about Apixaban as I take Warfarin. Just saying to Ashburton who I've met, that it would be an idea to not have the make that really disagreed with her and to tell her pharmacy why she doesn't want it again.
Ahh - as the question asked for experiences of Apixaban, I presumed your answer re brands related to your experience of Apixaban. Thanks for clarifying.
Sorry, I can confuse anyone - even myself.
Thats interesting - Accord is a brand that I cannot take, my prescription says no Accord, Activas on it. I have to be careful of lactose content, I know most medication has lactose in the filler but I think Accord has quite a high amount. I take Nebivolol and for ages was fine with what was suppled but when all the generic drugs started to appear, each month you never knew what you would get, I had a lot of problems with various manufacturers. It has taken nearly a year to get my monthly prescription sorted, most of my medications now have named suppliers. Most of the problems I believe are wth the fillers, lactose, additives ect which I know Jean you have problems with and are carefull with.
I’ve had no problems but everyone reacts differently and I certainly have had side effects of the same drug with other generics. As Jean says, if you can get the Manufacturer which suits you and GP agrees to specify on script - that can work.
I did not realise there were different manufacturers of the same drug - I thought they all still had patents ! Here is SA, Apixaban is only Eliquis, and Rivaroxaban is only Bayer's version - used to be Xarelto is now iXorolo - but is exactly the same packing and box save for the Africanised name !
I think I am definitely tired. I also had terrific itchiness for a while and an allergic reaction . But overall better than having to have regular blood tests ( I was on warfarin) Also there is no longer a list of foods I should avoid
I have had several manufacturers of this medication and all have seemed to be fine or that I haven't noticed any differences.
I do however think this has happened to me regarding another medicine, and had bad sides from a certain manufacturer. 🤔
My experience having worked in the pharmaceutical industry is that generic drugs are rarely anything other than identical to the branded original. With DOAC drugs being such an expensive and complex drug to manufacture, the chances of any issues are vanishingly slim.
The chances are much more likely that some change in absorption or an interaction of some kind occurred, which should be a one off occurrence.
Are the problems repeating with subsequent doses? If so, would you doctor be willing to issue a new prescription naming the branded drug? This is what mine did with a different drug when I suspected there had been formulation changes but, in the end, this proved it wasn't the generic but yours truly.
Steve
My wife had been on Eliquis apixaban for well over 10 years. Teva and others challenged the validity of the Eliquis patent and Teva entered the market with their own version of apixaban. My wife got switched to the Teva product and experienced real problems, including depression, anxiety and nausea. The GP changed the prescription back to Eliquis and all the problems resolved. So maybe you need to insist on Eliquis.
My pharmacy often has to source medications, including my Apixaban, from different sources these days. Thank Brexit for that. They just have to get them from where they can now. My symptoms don’t seem to change from manufacturer to manufacturer. Maybe your pharmacist would be able to help/advise
yes I had that problem and my pharmacist asked the doctor to always request on repeat prescription eliquis which is the one that suits me
Good luck
Like you my Apixaban changed four times and the last one I experienced light headedness which had never had before and also tiredness. My GP said that the pharmacy just get the make that is available as not all are. Doesn't solve the problem though.
So don't know what the answer is - perhaps going on to a natural anticoagulant??
My supplier has changed from branded Equilis, to the generics, initially from Mylan and now Teva. I have not noticed any difference and I’m happy for the NHS to use it’s limited funds more cost effectively elsewhere, rather than on expensive branded medications.
My Doctor's pharmacy gives out the one made by Sandoz in Surrey GU15 3YL, and I have not noticed any difference. They changed some years ago now. There is no such thing a natural anticoagulant to my knowledge. I'm over 80 now but I don't have any side effects. The Apixaban gives a 20 minute clotting delay so protecting you from a stroke as the blood has time to pass through your brain.
All the best.
Roy
You could ask your GP to prescribe it specifically by brand name or manufacturer. I take an opiate painkiller and I'm allergic or have bad reactions to the generic brands. There's only one other manufacturer I can tolerate so my G P prescribes it by brand name. It's the fillers and/or colourings some firms use that affect me badly. If you look at eh box you will seethey all have the same main ingredient but the other bits that go into he tablets can change de pending on who makes it. Make a not of which ones you can tolerate and ask your GP. Your chemist may be able to just send you certain brands bu t sometimes the ones you want may not be available. I have a couple other tablets that he chemist tries to make sure are the best ones for me.
The brand name is ELIQUIS. I was originally prescribed by that name then my next script was just for Abixaban so I was given a generic which caused stomach problems. I got the Doctor to always write ELIQUIS on the script and I tolerate it very well.
Im on 100mg Asprin at the mo but docs are not happy eith that one really. I threw the rivaroxaban and then pradaxa away, as after 6 years they both gave me terrible all night nausea in the end. No nausea at night now but waking with palpitations at night which i deal with by taking a 40mg verapamil tab and reading for hslf hr then trying get back to sleep. Its a terrible thiing this AFF. All the best for you, colin in NZ, so writing in the small dark hrs here.
Thank you so much everyone for your very helpful replies. It is a bit of a minefield though isn't it. But it sounds like you have to insist on keeping to a particular make.
Thank you all again
I was put on Warfarin in January 2010. In April 2010 I bought my own Coaguchek testing device and have self monitored my INR test results ever since with the support of my Surgerys INR Clinic. In Nov 2023 I was taken off Warfarin and put on Edoxaban which gave me vile nightmares and loss of sleep. It was suggested that I try another NOAC but I refused - once bitten, twice shy so I am now back on Warfarin. Needs to be said Warfarin is demanding but there are many folk such as I who cannot take any one or indeed any/all of the NOAC's. The thing with Warfarin the INR testing process needs some discipline and organisation. But it has been around for 70 years or thereabouts.
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