My pharmacy is unable to get Apixaban at the moment. As soon as I was aware of this I cut my usual 5mg in half (I think that is alright at my age - 81) but I am now coming to the end of those. I have found some old ones, I don't know why I kept them but obviously I did. However, they expired in November 2023 - the leaflet states not to take after expiry date, but it would say that wouldn't it?! I am wondering if it is better to take them than to take nothing, or could they possibly do me harm although there is nothing to that effect on the leaflet. I just wonder if anyone has any advice or experience. And, is the shortage of Apixaban general throughout the country?
Apixaban: My pharmacy is unable to get... - Atrial Fibrillati...
Apixaban
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Tricia239
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Hi Tricia - your question re past sell by date is one for the chemist. However, if it was me I would consider the situation to be an emergency and be straight on to GP or cardio department. If there’s a national Apixaban shortage then we’ll all be swapping to an alternative anticoagulant- at least in the short term. Good luck and hope you get this rapidly resolved. 🤞
Thanks. The trouble with the pharmacy is that it seems to be manned by the living dead and trying to get any sense from them is like pulling teeth! I've got an appointment with the pacemaker clinic tomorrow, I know they are not the ideal people to ask but they might be able to ask someone who does know and get a reply quicker than I can in today's broken system!
Thanks for your thoughts.
Can’t find any mention online of Apixaban being short supply, I got mine ok last week. I would phone other local pharmacies and see what they say, if it’s just your pharmacy being lazy then ask for the script back and go to one who can be bothered to help you.
That's interesting - I assumed there was a general shortage, so yes, I will do that. I was going to change pharmacy anyway because I usually have steam coming out of my ears when I'm in there because they are unbelievably slow - like I said, the walking dead!. Thanks
I got mine last week OK. I should imagine out of date ones are better than nothing but surely your GP could prescribe an alternative.
I guess they could and may well have to but only after I have wasted a couple of hours waiting for the phone to be answered! At least I now know from the replies that there isn’t a general shortage, so I’m off to do battle as soon as they open! Thanks. Tricia
As bantam12 has said I would phone other pharmacies to see who could supply them, then go to the one that had your prescription and ask them to print it out and give to you. Then go to pharmacy that can supply them.
I had problems with my old pharmacy getting my pills, then went to Boots and have never looked back. Being a large company I think they are well looked after by suppliers.
At times I've even rang the Company that makes my pills and asked if there's a problem with supply and they've told me which wholesalers my pharmacy can get them from.
Jean
Thanks Jean, that's really helpful. I will do that.
I was told by my grandson, a bio medical scientist who makes drugs, that the potency of out of date drugs is nor as great but for reassurance ring any pharmacy anywhere and ask them. Furthermore, we take these for a purpose and there are alternatives, as I found out when Disopyramide, a drug I had taken for 20 years, went out of production .
That’s what I had been told, in fact I was told that a lot of out of date drugs are sent gratis to Third World countries, but equally you need to know which drugs are ok. I will be on the case in a few minutes once they open. Thanks for your reply. Tricia
That used to be the case Tricia239 but no longer allowed.
Oh, interesting. It sure if that’s a good thing or not. Tricia
Your GP will prescribe an alternative. There is no shortage in my area.
There is no national shortage in the UK. Good luck, change your pharmacy and speak to your GP.
Dump your pharmacy! No shortage according to mine. As others have said, ring round all the rest to check they have it, then retrieve your scrip from them. If the original scrip had other drugs which they've already fulfilled, ring your surgery, explain, then get them to urgently fax a duplicate Apixaban order (only) direct to the pharmacy you've identified, and you should get be able to collect it today. If you are on a delivery order, also get your surgery to change the pharmacy. In any case, if you have a previous counterfoil of your scrip, you can obtain a week or two week emergency supply of any non-narcotic drug from any pharmacy on the spot. Please don't rely on that pharmacy again! All the best.
Curiously I was about to dump them anyway, the zombie behind the counter - who also professes to give advice (heaven help us) does my head in - as they say! Thank you for the very useful advice about the script. I have a hospital appointment this afternoon and so I will try the pharmacy there. Tricia
Have they offered you one of the other DOACs as alternative? I swapped from Xarelto to Eliquis and back to Xarelto (Eliquis gave me heart burn) with no problem. In fact at one stage, I asked my pharmacist what happens if they cannot get the one I am an and she says not yo worry as you can switch to an alternative.
It sounds as if your pharmacy is more helpful than mine. I think it’s time to rattle a few cages! Thanks. Tricia
Mine's in South Africa and always liaises with my doctor is there is any query, but I think and I hate to say this, but because it is a private system, but nor outrageously expensive like the USA, it operates on a different method (the only medical practitioners employed by government are those at State run hospitals and clinics) and they are very much in the minority as there are far more private hospitals, pathologists, radiologists and every specialty than in public service, we do get better service, because we can vote with our feet, and they need patients and customers, as they have no guaranteed income from the government.
Are there not other blood thinners you could take?
Yes, and it may well come to that. Thanks for your suggestion. Tricia
Hi Tricia, why not sign up to pharmacy to you, okay your not dealing with your local pharmacist but you wouldn't need to worry about getting your prescription, and it doesn't cost anything for delivery, (i don't work for them lol)
I hadn’t heard of them and will certainly look into it. Thank you. Tricia
If you ring 111 and explain the situation they will arrange a new prescription at a pharmacy of your choice. Or ring your GP.
It's hardly something you can do without,as your current useless sounding lot should surely be aware!
Thank you. I have just phoned my useless lot. They do not have any 5mg but do you have 2.5mg but can’t let me have them without a different prescription! Currently, steam is escaping from my ears!! so, thank you for your suggestion I will give it a try.
Such substitutions have been routine practice in hospitals (and in Scottish pharmacies) for years according to the Royal Pharmaceutical Society! You could always write to your MP about the waste of GP time.
Thanks, I am certainly going to write to someone. It cannot be right that they are happy to leave a patient without a vital drug rather than double up on the 2.5mg they appear to have plenty of. Plus not inform me when they knew there was a problem so that I could have done something about it before I actually ran out.
Where are you? No problem with availability in the UK as far as I am aware.Please don't take tablets that have expired, my friend is a chemist and has a pharmaceutical company, he always tells me never to take tablets that have gone past their expiry date, they can change form and be dangerous
Oh, thank you for that - I was very close to taking them. Thanks. Tricia
You will never get a medical professional to officially suggest you take a medication after it’s expiry date. What they say privately however may differ.
The expiry date of a drug is the date to which it has been tested to on stability and verified as still meeting the licence requirements. It does not mean that beyond this date it will not meet the requirements - they just haven’t tested it so cannot guarantee it. Drugs are not like fruit that will go off shortly after the BBE date. It is expensive to retain and test samples of every batch made and the longer the stated shelf life, the more and longer the batches have to be kept. Additionally, it can extend the time that it takes to bring to market if they try for a longer shelf life. It is therefore rarely commercially viable to have a shelf life longer than 3 years. Other than for antibiotics, I don’t worry about exp dates. A number of years back, the US army had a massive stock of expired drugs and commissioned tests to see which / how many still met their licence requirements. I understand, nearly all were ok some 10 years passed their expiry date.
This spring, I concluded that I was suffering from hay fever. Rummaging around in the bathroom cabinet, I found some prescribed Piriton (antihistamines) tablets with expiry date of 2008. Antihistamine was one of those tested by US army. Took the tablets, relieved the symptoms, no know side effects so now I know what works for me and can order generic on line.
Edit:
A caveat to the above is that meds should have been kept appropriately, ie stored in cool (< 25oC for most tablets), dark and dry conditions and either in their original foil blister packs (most modern meds) or if dispensed in bottles, care taken to re-close lid and avoid moisture.
The exclusion, in addition to antibiotics, should include nitro-glycerine and insulin Liquids and ointments are also best avoided.
Thank you for all the information, that is really interesting. My friends late husband was involved in the drugs industry and he always told her not to fret about the expiry date, so it is good to have a second opinion. Tricia
I would be cautious. My friend is a chemist and owns a pharmaceutical company in the UK supplying across the globe. He makes tablets and natural remedies and always tells me never to take after expiry date it is there for a reason. He informs me that drugs can change form after the expiry date and may become dangerous
Oh that's a bit worrying and it was something I was concerned about. I have had to have a real fight to get anything done but at long last I have got some half strength, which I will double up, to last me for 2 weeks. I think the pharmacy now realise they fell somewhat short of their responsibilities. Thank you for replying. Tricia
Can you not take your prescription to another pharmacy that does have apixaban. I am still getting mine OK and have not heard of any problems nationally - just had a repeat prescription this week. I have worked it that I always have a week or two left when I put in my repeat as my wife had problems getting some of her tablets once and we had to travel miles to get them. Whe then asked her Doc to let her have the repeat prescription early and for a few more tablets than she should have so she would be safe should this happen again.
Apparently what I have is not an actual prescription and I need to get one from the GP, but that takes hours to get (a) a response and then (b) for them to write it up. But I'm on the case but equally, not a happy bunny!
Can your pharmacy not ask the GP for an urgent script or can you not get into your GP's surgery in person and ask for an urgent prescription so that you can take it to another pharmacy?
I have done both. Apparently the surgery don't like to talk to the Pharmacy?! I phoned the surgery yesterday afternoon and they said they would arrange a script but the pharmacy said they hadn't got one, and when they checked it is still awaiting signature by a doctor. I was just so cross to have been left in the dark and consequently ran out. I don't think I have ever got so cross in a 'shop', politely cross I hasten to add but very much to the point and in fact apologised to the couple of other customers, all of whom nodded approving at me.
Fiddlee Dee! (Not the words I thought) What is wrong with people? Grr! Enough to make your blood boil. I am glad you told them what you thought of them. If you can I would make arrangements to change to a different pharmacy - just hope that doesn't cause other problems.
I’m going to, just need time to do it!
Hope everything goes well with it. I always worry when I change arrangements like this.
Thank you
I’m on apixaban eliquis and no problems. If I were you I would change the pharmacy.
Our Gp sends a digital prescription to our local pharmacy and they deliver it the same day or next morning. No problems.
Good luck
Thanks.
Can I change to your pharmacy (!) they sound brilliant.
Ha Ha! If you lived close to me you could change. Yes they are good and very nice as well. If I accidentally run out of any of my pills and forget to order, I phone them and he "loans" me some until the prescription comes through. When they were delivering a prescription last week I had two appointments and knew I wouldn't be in when they arrived, so they sent their son to bring them to me before I went out. So kind.
Amazing. It is so refreshing these days to get some good old fashioned service and someone who actually cares.
What brilliant service! Where do you live? I'm going to move there 
Our surgery and their pharmacy take 2 to 4 working days to get a repeat prescription done - it's usually 4 days however you request it. We can phone the pharmacy but not the GP, we can take a repeat prescription in to the GP's and drop it in a box or e-mail the GP. I think twice since we have lived here they have not been able to get something we have requested. I think they have two suppliers and neither of them had the medication so when we went to collect they did say we could take a prescription elsewhere or they could keep trying other suppliers. Even though they had some of the repeat prescription ready for us we couldn't have it because they and the other pharmacy couldn't fill part prescriptions. We were OK with that because we knew Boots in our County Town 15 miles away had it. So it worked OK. I always keep at least a week usually 2 weeks supply so that this doesn't leave me short if anything should happen. Otherwise the pharmacy have requested a prescription for the single item and a new script with just the items they have for us from the GP so they can supply what they have and we have collected the prescription and taken it somewhere else. In fact that time the receptionist took the script in to be signed by a GP between patients. Pretty good but not as good as your service Tapanac.
my pharmacy couldn’t get hold of 5mgs apixaban but could get 2.5mgs tablets. I thought the pharmacy would just give me double the amount of 2.5mgs tablets to fulfill the prescription but no I had to get a new prescription from the GP!
That's what mine have said. I think it is unbelievable that they will happily let you go without a vital drug rather than double up on a half strength. Apparently it is something to do with pricing - my view is, it is their responsibility, sort it - don't make it my problem! Call it a service, what a joke. I'm absolutely furious. Why didn't they phone me when they made up the rest of my repeat prescription that there was a problem and would I like to try elsewhere, instead they did absolutely nothing, not even send the usual text when the meds were ready, just left me in the dark. Mutter, mutter!
Oh our pharmacy have been Ok doing that for me once just take two tablets instead of one. I imagine they had to tell the surgery and a new script was sent in - they are next door, but they had no problem doing that.
Been able to get it locally in East Sussex and at Boots in Livingston Scotland OK. And I always keep a spare box in my draw just to make sure I never run out as it could have disastrous consequences.
All the best.
Roy
Thanks, yes I always keep spare but just hadn't realised they expired Nov 23!
I always use the previous one, keeping the latest one for next, so that they never are past their expiry date, only ever more than a month old, so never past or even near, their expiry date.
All the best.
Roy
Sadly I only have one brain cell!!!!
I have taken tablets that are out of date by more than that - as sure they are OK. My wife has taken over storage of medications as she is a stickler for "stock control" and uses the oldest boxes first and stores all my medications in date order in a plastic box in our garage - cool and dry and out of bright light - which is how I believe most medications should be kept - though this year even the garage has been getting warmer than normal. We have noticed also that we will get a box say in May with a date on and then in June or July's repeat we will get a box with a shorter (sometimes much shorter) date. So you have to be careful when storing that you check the dates and don't just imagine that the newest box has the longest date.
Some of my medications are date sensitive and actually can only be stored for a certain amount of time - one has to be stored in the fridge too. Half the time I can't see the darn dates. On one med they were just indented so no ink showing - how do they expect an 80 year old with macular degeneration to see that for goodness sake - I know they don't expect you to store meds but then if you don't and one month you can't get your repeat in time like you now and us a couple of times in the past then what? Mind you, I only have a small box of meds stored. My wife's elderly Aunt and Uncle had 4 or 5 bags for life full in the airing cupboard! Most of which were years out of date and some were no longer prescribed for them as had been changed. They were in their early 90's and thought they should keep them and not waste them in case they needed them! Not only but also my Mum and Dad in their mid 80's thought when they were put on monthly repeat prescription that they should throw out what was left from the previous month and just use the new ones - you know the fresh ones because the others had "gone off" - goodness knows how long they had been doing that before we noticed when visiting them. We got my Mum's visiting carer to do the tablets after that. I wonder what I will be like in my late 80's or 90's if I live so long? Aww looking at that I think "Shoot me now!" LOL.
Have you p honed other pharmacies in your area? It may be that yours only uses one distributor or one brand. Others may have some in stock. IT's urgent now so sp eak to your GP too. If you find somewhere that has them you will need a new prescription. The bigger pharmacies tend to keep stock on the shelves. A hospital pharmacy can give an emergency supply but you must speak to your doctor.
I am going out shortly and will, 'do the rounds', no doubt including GP. But, thanks.
Absolutely, we have had this happen to us a couple of times with our GP's pharmacy - smaller than my front room. We usually find that Boots always has supplies so have to drive 15 miles to get to one.
I realise you were concerned about running out of Apixaban but I wouldn’t experiment with lowering your dose without some genuine expert advice. I took Apixaban for a number of years following a DVT (and PE before that) but when I experienced another DVT, whilst taking the maximum Apixaban that I could, I was swapped to Warfarin. As others have said, get some proper advice. Good luck. 🙂
I will do, thanks.
Yes, I agree with Neil2020 re taking advice from your medical experts about any change to a half-dose apixaban regime. The research below concluded "low-dose apixaban was associated with a greater risk of stroke/SE and death without a reduction in the bleeding rates" ...
Effectiveness and safety of low-dose versus standard-dose rivaroxaban and apixaban in patients with atrial fibrillation:
The suggestion was not changing the dose but taking 2 x 2.5 rather than one 5 I believe which the pharmacy seems to have but don't have the 5mg. My pharmacy have done this for me in the past with a medication and I presume have had the Doc send a new prescription through to cover them for that. It's OK if you remember to take two of the 2.5 and not one and then don't get mixed up when you get your next repeat for the 5mg. Easily done - especially as you get older. I surprise myself and have a good laugh at all the new stupidity I find in myself all the time as I get older and older
Hi Tricia...I worked as a pharmacist for many years. if the tablets were kept dry and not exposed to high heat, didn't look physically deteriorated..I would take them. I would also call some other pharmacies to see if they have the drug in stock, and if so, ask them to transfer the prescription record from your present pharmacy. Asking them to give you back the prescription after they have filled it once isn't possible. I wouln't cut the dose in half until I tried everything else.
Thanks, I've now managed to get enough 2.5 to double up and last for 2 weeks, during which time hopefully things will be sorted out. I really had to fight though - in the end the Pharmacist did apologise. It was the fact of leaving me in the dark which made me so cross, I think they have got that point now. One assistant said, 'oh we can't phone every patient....' so I rather lost it at that point and said something to the effect, 'OK, so I'll just die on the floor here shall I?' I've calmed down now, and in the end the pharmacist and I parted thanking each other.
I've been taking Tramadol (for a recently-pulled and very painful back muscle) which I found in a cupboard and are so old I can barely remember having them prescribed. At least 20 years ago anyway. They work fine and I'd have been amazed if they didn't. I'm certain that a dry product kept in ambient temperatures, in sealed foil cards is not going to change in a matter of less than a year!
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