Advice

[highbury44]

I did a post a few weeks ago ,regarding commencing anticoagulants on a regular basis,previously had a PIP arrangement.Well my GP got clearance from a Cardiologist at the local hospital ,so I was good to go.I already had a supply of Apixaban ,previously prescribed by another GP,so I didn't need another prescription until this week.I used the Amina system to message the GP,but I got another GP who advised me to stop taking the Apixaban as all 3 previous doctors had not arranged a blood test to check how my blood clots before the anticoagulants were prescribed.Ironically I asked the last GP that specific question but he said this was not necessary.The problem I have now is my PAF has literally feel off the cliff edge with episodes of 12 hrs or more daily,but the GP needs me to be off Apixaban 72 hrs before having the blood test.I am not comfortable being in potentially in AF for the best part of 3 days without any anticoagulant,with the risk of clots.I feel I am now in between a rock and a hard place.Any advice would be great

[wilsond]

I have never heard of blood tests being necessary for commencing apixaban or other noacs.I wonder if this gp is confusing it with Warfarin?

I'd contact your cardiologist or his/ her secretary right away and ask them to instruct your gp with their recommendation to start Apixaban.

Good luck,and you are right to be concerned.

[highbury44 in reply to wilsond]

Thanks.It is very frustrating when GP,s give different advice for the same issue.I haven't seen by Cardiologist since 2018,and he is now retired.I am awaiting an appt with a new Cardiologist ,hopefully in Oct 2024,re ablation.

[wilsond in reply to highbury44]

If funds allow,book an appointment with an Electrophysiologist, private. Costs around 200 pound see within weeks. They are even better than Cardiologists. But I'd still contact your new Cardiologists secretary and tell them the problem right away.

It's a fair way off until October!

[highbury44 in reply to wilsond]

I am not certain of the name of my new NHS Cardiologists .I will contact the appointments dept tomorrow to find out.I feel ok in AF and it doesn't stop me doing anything ,however long term it can cause damage to the heart,so I am looking at getting it back to NSR on a regular basis.Money is not an issue so I will look into the private route as well.I am some what surprised however,how quickly it has changed.

[BobD Volunteer]

I feel sure your GP is confused. DOACs such as apixaban do not need testing . That dates back to warfarin (which I have been on for 20 years now.) Can you get a second opinion or maybe change your GP?

[highbury44 in reply to BobD]

Hi again Bob,I understand you don't need a blood test for clotting,once you are on the anticoagulants,but should you have one before you start,as the GP is stating?

[BobD Volunteer in reply to highbury44]

Why? You are prescribed an anticoagulant for stroke prevention. I have been involved with AFA since long before DOACS were available and never heard of pre presciption testing. With warfarin you used to be tested every day the first time you took it until reaching target INR and thereafter according to how well you stayed in range.

[highbury44 in reply to BobD]

Ok thanks

[highbury44]

Thanks for your reply Bob.When I sent in the request through Amina ,it was directed to the previous GP,but unfortunately she picked it up.On the other occasions when Apixaban was prescribed ,they just checked kidney function,which on this occasion has already been done in May.Well I think I will continue taking the Apixaban and get an appointment with the previous GP as he specifically said I didn't need any blood clotting check.

[bantam12 in reply to highbury44]

I never had any bloods done before starting Apixaban, think your GP is confused as others have suggested.