Medication dosage

[Calypso76]

Hi, everyone here is so helpful that I feel confident to share my concerns and confusion with you. Please bear with me. I was recently diagnosed with AF and put on Eliquis, which I have not yet begun to take for so many reasons. First and foremost, I'm scared of the bleeding side effect (I've had bleeding in my stools twice), then I have kidney issues and I've been given a 10mg dosage twice a day. Is anyone on 10 mg? I'm 76 female. I read an article in Medical News Today that only mentions side effects of 2.5 mg vs 5. Why was I given 10mg? I appreciate your support.

[mjames1]

This should be a question addressed to your doctor, which none of us here are.

However, I will say standard dosing for afib is 5 mg bid (twice a day) and in certain cases 2.5 mg bid.

My understanding is that 10 mg BID is only for DVT (deep vein thrombosis) and then only for a short period of time before reverting back to 5 mg bid.

Jim

[Calypso76 in reply to mjames1]

Thanks for your quick response. I did read that standard is 5mg, 2.5 is for people 80 and over. I'm calling my cardiologist tomorrow to make an appointment. I'll keep you posted.

I forgot to add that I have bradycardia, my HR is usually in the 50s, so I wonder if such a strong dosage would drop it even further.

[TracyAdmin Partner]

Good Morning

Anticoagulants are a vital component in protecting you from the high risks posed from having AF - an AF-related stroke. It is well known that some of the common side effects from the medication is the risk of bleeding and bruising. It is understandable to not want to take the medication so therefore you must raise your concerns and discuss with your own doctor who will be able to respond to your question about dosage. You may also wish to download our 'Preventing an AF-related Stroke' booklet from our resources tab on the AF Association webpage:

US: api.heartrhythmalliance.org...

UK: api.heartrhythmalliance.org...

booklet

[wilsond]

That sounds odd. My husband had a dvt and even he was only on the same dose as I , 5mg twice a day for 6 months, then 2.5 indefinitely. I'm on 5 mg twice daily for life.

Never heard of anyone being prescribed 10mg twice ( in other words 20mg!!).

Please investigate surely not right!

[mjames1 in reply to wilsond]

Never heard of anyone being prescribed 10mg twice ( in other words 20mg!!).

"...have recently had a blood clot (within the last 6 months) is two 5mg tablets taken twice a day, for the first 7 days. After that, you'll take one 5mg tablet twice a day..."

nhs.uk/medicines/apixaban/h...

Jim

[Calypso76 in reply to mjames1]

Thanks for your response.

[wilsond in reply to mjames1]

So did my husband dvt in leg. He was given 5mg twice daily for 6 months then 2.5 x 2 indefinitely

[Calypso76 in reply to wilsond]

Thank you! Others here have said the same thing. I intend to take this up with my doctor.

[mav7]

I've had bleeding in my stools twice

As I understand your post, this is without taking Eliquis ?

If so, not always unusual depending on other factors but suggest discussing with your GP.

And with due respect, verify that dosage. Are the tablets .5mg or .10mg ?

And suggest talking with the prescribing doctor about your Eliquis concerns.

[Calypso76 in reply to mav7]

Yes, this is without Eliquis. My doctor thinks it's due to diverticulitis. After this happened the second time they had me do a colonoscopy but found nothing. That's when they went ahead and put me on Eliquis, but I'm still concerned about the bleeding side effect. I forgot to mention I also have kidney problems, but my cardiologist said it's okay to take Eliquis. Thanks for your response.

[DrBook in reply to Calypso76]

I'm sharing an edited response to a recent post as I believe it's relevant to your post. I had a serious gastrointestinal bleed (a diverticulum was bleeding) last October not long after starting an anticoagulant (Rivaroxaban) for Afib. A gifted interventional radiologist and his team performed an emergency procedure to stop the bleed. I have no way of knowing if the anticoagulant caused the bleed but it certainly exacerbated it. The anticoagulant was stopped for several days and I was switched to an anticoagulant less likely to cause bleeds (Apixaban). I should also mention that the interventional radiologist noted that I was at high risk for another bleed (due to a history of acute bouts of diverticulitis). In spite of all of the above I chose to continue anticoagulant therapy. In my mind, the risk of a stroke far outweighs the risk associated with taking an anticoagulant and I experienced what many people fear most when taking an anticoagulant. With that being said, only you in consultation with your doctors can decide what is best for you given your particular situation. I wish you all the best as you make your decision and my hope is that you won't make your decision based solely upon your fear.

Brian

[Desanthony in reply to DrBook]

Eliquis is the brand name Apixaban is the drug - the active ingredient in Eliquis. I get on well with Eliquis. Previously I had a gut and bladder problem that caused bleeding but it has not got worse since being on apixaban. I have check ups, scans etc regularly to check on the situation with bladder and gut but neither has got worse whilst I have been on Eliquis/Apixaban. Been on Eliquis/Apixaban for just over 8 years and had no problems - don't even notice that I bleed more or for longer when I cut myself gardening. That reminds me it's nearly time to cut back the rambling roses again and they really are rambling a lot this year must be due to the damp warm weather so going to be covered in scratches and cuts soon.

[Calypso76 in reply to Desanthony]

Thanks for your encouragement. I'm glad to hear you're doing well on Eliquis. Wish I could see your roses.

[Desanthony in reply to Calypso76]

Ah we have had heavy rain overnight so they are mainly petals over the path and garden now. One flowered early this year so has finished blooming but failed to prune that back when it finished flowering to make the exercise a little less intense by having to do all of them together. Another two are on their last blooms now but one is still blooming nicely. Last year we had loads of visitors so didn't get things done when we should and then rain which stopped everything - not just showers but it seemed like weeks of heavy battering rain. This year again 4 weeks and 4 different lots of visitors, weddings and 70th birthday dos and dog sitting and one last retirement do to go to so hoping to be able to get out there and blitz it next week when we have good days. Today is our first week in over 4 weeks when we have nothing to do and no where to go and no visitors - well yesterday was but spent that doing all the washing again! Its really wet today and all we want to do is sleep! Can't wait to get back into our usual routine.

[DawnTX in reply to mav7]

I have had a little bit of blood usually it’s red and fresh and my doctor believes it’s my constipation that I get from one of my medication‘s. It’s only happened twice. He also reminded me not. Everything is heart related. The minute anything else is off we jump to the conclusion it’s the heart. He has assured me how well mine is doing now and that people without a pacemaker would like to have the numbers, etc., that I have. I have been on xarelto from the first time I saw my EP he is suspected it was a fib so he put me right on it as a prevention. You can always stop taking it but once you’ve had a stroke, it’s a little late. I had blacked out a couple of times. One thing I have had him posted on me recently that I had not heard before is that your anti coagulant should be taken the same time each night or no more than two hours different. I didn’t think to ask why because it’s a simple enough thing to do. I will admit I’m usually not very good at taking meds when I should. I have changed a routine so I am better. My cousin set an alarm for his, it’s probably the smartest to do

if you’ve had blood tests and heaven come up with anemia, etc., I wouldn’t be worried about some showing of blood. Just make sure you ask about it. People get hemorrhoids and polyps. All kinds of little things temporarily don’t let it. Keep you from taking some thing that could save your life from a stroke.

[opal11uk]

I cannot comment on this particular drug but I take 110 mg capsules of Pradaxa twice a day and formerly Warfarin, have taken anticoags for over 20 years after having stroke caused by A/F so, whilst you are always right to question and research the prescribed drugs, especially considering your other 'problems' , it is advisable to get your questions answered by a medic sooner rather than later to protect you from having a stroke.

[JOY2THEWORLD49]

Hi

You could opt for PRADAXA 110mg twice a day.

Blood in your faeces - you need to tested for colon cancer.

I've been on it for 5 years in September.

Stroke is the result of AF causing a blood clot because of the irregular heart beat the blood not being pumped totally and regularly from the Atrium down to lower chambers of your heart.

My stroke was embolic (a blood clot) caused by AF caused by thyroid cancer which showed up in a carotid arteries scan on Day 4.

I was not on any meds simply B12 nugget under the tongue 3 x times a week.

So it is up to you whether you take a preventative approach. I chose PRADAXA twice a day because it means I dont have a large dose which twindles down to nothing and again I am struck with a large dose to start the next 24 hours. Forget and take 1 and then another too soon there is an antidote, forget and you can catch up without risk.

I've had 3 ops (not heart) stop for 3 x 24hr days op and start again 2 days later x 24 hours. No trouble and one of the ops the surgeon was scared of bleeding. Never happened.

See how whichever one you choose ut I would choose twice daily.

cheri JOY. 75. (NZ)

[Calypso76 in reply to JOY2THEWORLD49]

Thank you, Joy. Please see my reply to Dr Book below. It turns out I'd made a terrible mistake, so it looks like I can take the apixaban after all. I was screened for colon cancer and nothing showed up.

[secondtry]

You mention kidney problems. Suggest you also ask your doctor if another reason for reducing AC dosage could be relevant if the kidney's are not clearing it efficiently.

nb too good a kidney function I understand can also be a problem in clearing the AC too quickly, particularly relevant if you are on 'once a day' such as Edoxaban.

[Calypso76 in reply to secondtry]

My kidney problem is the main reason I was hesitant to take the anticoagulant, but my doctor said it won't hurt my kidneys, so I have to trust him. Thanks!

[Vonnegut]

I no longer take an anticoagulant as haven’t had an episode for over 18 months now and when I took them the first resulted in dreadful diarrhoea and the next with constipation and I developed lots of small bruises too! Still here at 80 and remember what a lovely EP told me, that I was not at risk of stroke unless my episodes were long with a very high irregular heart rate which mine never were.

[DawnTX in reply to Vonnegut]

i’m sorry all I can say is how much I disagree with what you said. Everyone and anyone can be at risk. Small bruises are normal. I’m glad you’re still here at 80 wouldn’t be great to say 90 or 100. Yes I have had both problems. I don’t even know which of my meds are causing things because I take several. It’s still better than having a stroke. I wish you luck in your decision. I’m surprised your doctor encouraged you.

[Vonnegut in reply to DawnTX]

It was an EP who told me- the type of cardiologist who specialises in electrical problems of the heart. I am taking statins though as a younger friend who stopped taking hers had a stroke during an operation for cancer and it has affected her very badly. As I have never been overweight in my life it seems odd but as they don’t seem to come with the nasty side effects that the anticoagulants did I am continuing to take them. And as I haven’t had an AF episode for ages and that last one was stopped in a few hours with an extra Flecainde, I am hardly at risk of stroke from episodes if I don’t have any!

[pusillanimous]

Please go to your doctor and discuss it, especially if he/she is a GP - - they have so many things to deal with that sometimes they do get it wrong (they are only human). My GP originally prescribed me Eliquis 2,5mg once a day - I knew that was wrong, I knew that the dosage for my age and weight was 2,5mg twice a day - but a quick call from my pharmacist when I went to have the prescription filled, soon rectified the matter.

[Karendeena]

Are you sure your dosage isn't 10mg per day split into two 5mg doses? I was like you, scared of a stroke as my father died at 60 from a cerebral haemorrhage (he was on warfarin and fell). Having said that, I have just witnessed my older brother suffer a series of strokes from undiagnosed afib taking his left periferal vision. His world has come to an end as he can no longer drive. I want to reduce the risk of that happening to me so I take apixaban and have done for the last 4 years. I weigh up the risks against the benefits. I will be on apixaban for life. I am 67 years old.

[Calypso76]

I have egg on my face, y'all. After reading your very thoughtful replies, I decided to go and check the dosage on my bottle once again and guess what? It is 5mg x2 daily. I'm so glad I haven't spoken to my doctor yet and thankful for all your replies. One can never be too careful. Thank you!