Rivaroxaban (Xarelto) vs apixaban

[Calypso76]

I recently posted about problems dealing with the side effects of apixaban, mainly lightheadedness and dizziness. I saw my cardiologist today and he changed it to rivaroxaban 20 mg once a day. In reading about the side effects of this drug, I see that it causes "serious bleeding" among other things, including dizziness. Has anyone changed from apixaban to rivaroxaban and had a better experience, or have you always been on it and are happy with it? I look forward to your very helpful replies.

[SlothOnSpeed]

I have been on Xarelto 20mg for 10 years with no issues.

[meadfoot]

I have been on rivaroxaban for 12 years no issues.

[Jishuang44]

I have been on Rivaroxaban for 6 months. The only issues with it for me have been easy bruising and that minor cuts or scrapes can bleed for quite a long time so you need to be careful.

[Lilypocket in reply to Jishuang44]

Just a small question. My Dr has changed me from Pradaxa to Rivaroxaban. Pradaxa has a reverse agent ( antidote) but does Rivaroxaban have one in case of a serious bleed?

[Thomas45 in reply to Lilypocket]

I don't know, but DOACs have a short half-,life, that is their effects wear off quite quickly. One DOAC caused me great problems so I went back to Warfarin. On one occasion I fell cutting open my leg, somehow. It bled so a clean towel was held against it to slow the bleeding until the ambulance arrived. I was in hospital for three days, during which time the wound was closed, dressed often, and the bleeding reduced significantly. Subsequently I had the wound redressed 3 times a week at my local medical centre. After about 3 months there was no blood on the dressing.What was significant is throughout all the time I took my usual dose of warfarin. It would have been easy to stop the anticoagulant to stop the bleeding, but medics considered my taking the anticoagulant was my first priority. The scar is 4 inches he's by 1.5 inches,, near to the shin.

[Lilypocket in reply to Thomas45]

Thanks for your reply. Which DOAC didn't agree with you so to speak ?

[Thomas45 in reply to Lilypocket]

What I didn't do was go from one DOAC to another. I noticed you have many replies saying people have been on Rivaroxaban for many years without a problem, but don't appear to have switched from Apixaban to Rivaroxaban.I understand that Rivaroxaban needs to be taken with a meal containing fat. I was not told that, and as I don't have such meals, it may have contributed to the reaction I had from Rivaroxaban.

My newish arrhythmia nurse has tried, unsuccessfully to get me to change from warfarin to another DOAC.. I have my own INR test monitor and email my results to one of the clinical pharmacists employed by my medical practice.

[Lilypocket in reply to Thomas45]

If Wafarin suits you why change? I never understand why if a patient is happy with their meds they try to change them

[Thomas45 in reply to Lilypocket]

My original arrhythmia nurse assumed that because she had an evening meal at 6.30pm that everyone else did. I was told to have my warfarin at 6.30 each evening. Initially my INR, the measure of coagubility of the blood, would not stabilise, so I was put on Rivaroxaban.

I now take all medication when I go to bed, plus asthma inhalers at night and 12 hours later. (I have asthma as well as AF)

[Calypso76 in reply to Thomas45]

Thanks, Thomas45. My doctor said I must take it with the heaviest meal, whatever time that is. For me, it's usually lunch around 1:00, but today, the day I'm starting it, I have to take my husband to a 1:45 appt. and since I don't know how my body will react to the new drug, I'll take it with my evening meal. I'll make it heavy enough. LOL

[Lilypocket in reply to Thomas45]

Thanks for your reply.

[Lilypocket in reply to Thomas45]

So your 1 in 100,000 bad reaction was to Rivaroxaban if I understand correctly?

[Thomas45 in reply to Lilypocket]

Yes

[Calypso76 in reply to Lilypocket]

Andexanet alfa (Ondexxya) is an antidote for rivaroxaban. I just looked it up.

[Lilypocket in reply to Calypso76]

Thanks 🙂 I obviously haven't kept up with DOACs and their antidotes - thought Pradaxa was the only DOAC that had one.

[Dudtbin]

my husband has taken rivaroxaban for about 6 years with no problems.

[Ppiman]

These are all from the same family, called DOAC drugs, and so have nigh on identical potential side effects, including bleeding. I switched from rivaroxaban to apixaban as that's said to be better at stroke prevention in one study. Many here take edoxaban. I think they are all similar, to be honest.

Steve

[Lilypocket in reply to Ppiman]

I read that too.

[iris1205]

13 years on Rivaroxaban - no issues. I did not tolerate Apixaban well, it increased joint pain- hence switched back to Rivaroxaban. Our reactions are often unique to each of us - just like Afib!

[Cavalierrubie]

l tried all of the DOAC’s and unfortunately l couldn’t tolerate any of them. Side effects were awful, but then l am sensitive to most drugs. Last resort was warfarin and thankfully l am ok. Only thing is, you have to go for INR checks to make sure you are in range. Once l was stabilised, l can now go every 6 weeks and it takes about 3minutes with just a finger stick, like blood sugar check, so not a problem for me. I am not restricted in what l eat and have everything in moderation.

[Calypso76 in reply to Cavalierrubie]

Thank you for your reply. I'm glad you're doing well. From what I've seen, most people on warfarin seem comfortable with it. Was your INR check always done with a finger stick?

[Cavalierrubie in reply to Calypso76]

Initially, l was under the hospital so it was a full blood test, but they transferred me to the care of my GP., and the GP surgery has a warfarin clinic as do most practices and they use the Coagucheck device which is just a finger stick. Lots on here have their own machine and get the testing strips by prescription, but my surgery refuse to pay for them so l don’t have my own machine. They are very expensive to buy, Hope you soon get stabilised on the one that suits you. It takes a long time going through them all if you have problems and l was ill for quite some time.

[Calypso76 in reply to Cavalierrubie]

Thanks for that info. My husband is diabetic so he has the machine and sticks his finger every morning. He hates doing it but has to keep checking that his sugar is under control. I hope I don't have to go through that. I'm glad you're feeling better.

[WhitstableWanderer]

6 years on rivaroxaban without any issues. It's the only pill I've ever taken that doesn't give me side effects... but you must take it with a meal, not just a snack. 20 mg is a 'normal' dose

[Calypso76 in reply to WhitstableWanderer]

Thanks, everyone, for your prompt and encouraging replies. So it looks like riva for me. I'll update you in a couple weeks to let you all know how I'm doing.

[Thomas45]

Because all DOACs are similar, having had a very bad experience with one of them, I have been " bitten once, so I am more than twice shy of the rest".We are all different. I was the one in 10,000, or is it one in 100.000, who took a DOAC and had an auto-immune response, Polymyalgia Rheumatica causing severely aching bones and stiffening joints which was relieved by a very slowly reducing dose of prednisolone. It took 4 years to get off the prednisolone, which caused osteopoenia, so am on tablets for life to decrease the porosity of my bones. I had only taken 12 tablets of the DOAC.

But no need to worry for you, as while you have had some side effects of Apixaban, they're not in the same league as my response to a DOAC.

I take Warfarin, which doesn't restrict my pescatarian diet.