apixaban

[Foresttime]

The pharmacist has given me Sandoz Apixaban rather than Eliquius Apixaban. I was not spoken to about it just found it in the bag with my other medication when I got home. What I’d like to know is, has anybody else had Sandoz Apixaban and had any side effects that were not there with Eliquius, namely anxiousness and discomfort (maybe anxious feeling) in upper abdomen. I am thinking of not taking it anymore if I can’t have Eliquius named on prescription.

[BenHall1]

...that's what I like about warfarin ...none of this messing about with 4 different product brands. Warfarin = 1 product, 1 result then choose yer own diet. Sorted !

( that should jar a few nerves for today ).

[baba in reply to BenHall1]

There are in fact several different warfarin brands, see attached screenshot for some of them.

Screenshot

[BenHall1 in reply to baba]

Thanks. And my brand isn't even on that list !!

Anyway it's the INR that counts, not the brand. Did my own INR test this morning ... next is 7 Jan 2025 ( 10 weeks away). Sorted !

At least I know I'm okay as I am always in range.

[paolina in reply to BenHall1]

Think there's just one brand here in Italy Teofarma. I've never been offered any other.

[Peebles1 in reply to baba]

They are made by different companies but are all the same brand of warfarin

[wilsond]

Never had any problem with other manufacturers of Apixaban, have had Glennmark,Sandoz,as well as others inc Eliquis.No difference. You'd be extremely unwise to stop taking this vital medication . Speak to pharmacist if need be.

There are sometimes supply issues with drugs and pharmacists have to substitute.

[Camelia23 in reply to wilsond]

I've found something out today! I thought there was just Eliquis Apixaban. Only been diagnosed since September 2019. Lol

[Foresttime in reply to Camelia23]

I thought the same until I was given Sandoz Apixaban a couple of weeks ago.

[bantam12]

I was given Sandoz this time because they couldn’t get Eliquis, I’ve been on it for a couple of weeks and not noticed any difference, in fact I’ve been feeling better so maybe that’s why 🤷‍♀️

[meadfoot]

My GP requests specific brands for me on each prescription. Pharmacies will give you whatever brand is easiest and least expensive for them to dispense. If a brand doesnt suit you side effect wise or whatever then ask for the brand that suits you the best, its your health.

The pharmacy said to me the brands you have are more expensive and we dont want to pay more, so I changed pharmacy.

[paolina in reply to meadfoot]

In Italy, I have to pay extra for any medicine that are not generic. I think it's quite reasonable though I suspect it wouldn't go down well in England.

[Peebles1 in reply to meadfoot]

If the prescription states a brand the pharmacy must give you that brand as that is what they will get paid for .

[TamlaMotown]

Hi Foresttime, I've taken I think about 4 different brands now just whatever I'm given & not noticed anything different at all. I was nervous about it at first but don't think about it now I know I'm OK.

Perhaps you have the anxious feelings because you are apprehensive about a new med & it will pass hopefully. I'm very good at doing that to myself.

[Foresttime]

Thank you for your replies I will speak to the GP about prescribing Eliquius only.

[pusillanimous in reply to Foresttime]

I live in South Africa, so out of interest I looked on the drug formulary for the Medical Aid Society to which I belong. Of the anticoagulants available, (Warfarin excluded) Eliquis is the cheapest.

[CDreamer]

Yes, no problem.

[RockingRoxy]

I am of the belief that whatever trade name a drug has it’s the chemical name ie Apixaban that dictates the actual drug you are taking so it’s exactly the same but made by someone else. Paracetamol and panadol are exactly the same but one is way more expensive. A pharmacist cannot give you a medicine that is different to what you have been prescribed but can give you a cheaper or more available medication.

I was a nurse for 48 years and this was the case all that time and can’t see how it would change.

I too have had a differently packaged Apixaban recently so guess the former brand is either in short supply or more costly. I have noticed no difference.

[paolina in reply to RockingRoxy]

It's the bulking agent which is different, and may cause problems.

[RockingRoxy]

Just to add it might reassure you to look at what medication actually contains rather than what it’s called. Hope you sort it to your satisfaction.

[Lu22a]

Hi! I have nearly always had Sandoz Apixaban and have not had any side effects whatsoever.

[Thomas45]

An anticoagulant is vital medication. Take it when it's prescribed. There are other anticoagulants to try if you have difficulties with your current one, but never stop taking it, without first receiving medical advice.

[Ppiman]

Having working inside the industry for many years, I would say that generic drugs are of an identical formulation to branded drugs, and will have been tested according to the same strictest pharmacopoeial requirements.

People say that some changes are possible such as in the kind of fillers and binders used to make the tablets, but this variation would also be allowed in the formulation of the branded drug and these are usually neutral chemicals such as magnesium stearate and cellulose.

Steve

[Auriculaire in reply to Ppiman]

The fillers and binders can make a difference with some medicines. This was shown with the Levothyrox scandal here some years ago when Merck changed it's formulation . Not only did people get side effects but many who had been stable for years on their dose of Levothyrox had big changes in their blood tests for TSH and thyroid hormone levels with the new formulation. It is well known among those with hypothyroidism that it is best to stick to the brand that suits you and that this differs among individuals.

[Ppiman in reply to Auriculaire]

The exception proves the rule, I would say but that would have been an unfortunate change.

Steve

[Auriculaire in reply to Ppiman]

Yeah well they took out the lactose having opened a giant factory in the country with the most lactose intolerant population in the world and tant pis for all the Europeans who were doing just fine on the old formulation.

[Ducky2003]

Mine changed from Elquis to Sandoz a few months ago and I haven't noticed any difference.

[BevCynfelyn]

I've been on Apixaban for 8 years and have had every different manufacturer version of it, whichever the pharmacy has in stock at the time.I think refusing to take lifesaving medication just because it doesn't have Eliquis on the packaging is possibly putting your life at risk for what? Pride? Snobbishness? OK I realise a few patients might have adverse reactions to some fillers like lactose and these might vary slightly from one manufacturer to another.

But really, is that a good enough reason to stop taking the medication that could save you from a life-limiting or life-changing stroke?

[mhoam]

Hi,

I am yet another example of someone who was on Eliquis for years when it was the only brand of Apixaban available but who has had multiple generic brands over the last few years and seen absolutely NO difference between them at all.

There are plenty of problems to worry about when dealing with AF, the brand of Apixaban is NOT one of them!

Good Luck

[LaceyLady]

What annoys me about ‘dosing’ is the one size fits both sexes and never even include body weights! I’ve had an ablation end of February and had consultants ask why am I still taking the Apixaban 🤷🏼‍♀️ I cannot get any doctor to give me any sensible answers as to what I should do about it!! I’m sure this is down to the ‘Sue it culture’

[37Polly in reply to LaceyLady]

Finally got my doc to lower my dose to 2.5…needed to be two of three: less than 130 lb, female, over 80 year. Met all three!

[LaceyLady]

Yes they do recommend lower doses for older people, I’m 67 and tended to bleed without any Apixaban! But there is a does all the same attitude. If it were an animal, they dose according to size and weight!

I cannot find any qualified medic who will give me a sensible answer, just palm me off with go back to who prescribe them, guess what, it was the hospital that I was consulting the medic in!

[RoyMacDonald]

I can't tell any difference.

All the best.

Roy

[Peebles1]

If it states Eliquis on the prescription that is what you should be given as that is the brand name of apixaban. If they have given an unbranded version (sandoz) the pharmacy has made an error and you should go back and complain . However many GPs are writing prescriptions for unbranded versions of apixaban as they are much cheaper than the actual brand Eliquis. Check what is says on your prescription.

[Ersilia2]

The Pharmacist should have told you he gave you a different brand and given you an explanation just to assure you. Hope you’re ok.

[Peebles1 in reply to Ersilia2]

If the prescription says apixaban we give whatever make we have in stock as they are all the same. However if the prescription says Eliquis which is the brand name this must be given, we are not allowed to give an unbranded version as this would be a dispensing error.

[Retired2020]

I assume all these posts are from outside the US as currently only the brand name Eliquis is available until patent runs out. Am I correct?

[GordonEdin in reply to Retired2020]

It was only Eliquis that was available in the UK until about a year ago. Since then, my wife has been supplied with various alternative brands. I assume that the patent has run out - at least here. Don't know if different countries apply different lengths of patent protection.

Certainly, the NHS would switch to a generic as soon as possible. Apixaban used to be one of the most expensive common drugs - and initially you had to make a special case to go on that rather than warfarin.

Just noticed this article which said that generic Apixaban was available in the UK from Jan 2024.. Another article said that Eliquis had managed to extend their patent protection in the US to 2026.

pharmaceutical-journal.com/...

fiercepharma.com/sponsored/...

[Pitterpat]

I had to insist my doctor stated "Eliquis Apixaban" on my prescription otherwise the pharmacist gave me generic brands. I took 2-3 tablets of those once and it made me quite unwell. The actual drug is the same but the coating is different. I can't tolerate it. The doctor was fine doing this, but Eleqis has to be the first word on the prescription. Putting "apixaban, Eleqis brand" was unacceptable to my pharmacist who refused to give it to me !!

[Greenhilldrive]

I’m taking Sandoz Apixaban. It’s generic that has just become available and is much cheaper than Eliquis Apixaban which I was on.

For me, it’s a blessing because I have to pay for my own meds. I started taking them 2 months ago and have not noticed any unusual side effects.

I hope you find this helpful.