Rivaroxaban

[DIB69]

I've been taking Rivaroxaban for over 5 years and continue to notice some bleeding of the gums when brushing my teeth and when blowing my nose 3-4 hours after taking it. I have spoken to my GP who seemed generally unconcerned and mentioned the option of changing to Apixaban. I've also noticed that I'm now issued with a generic brand of the drug and wonder if this makes a difference as the bleeding seems a little more evident. Has anyone else had this experience and changed their once daily DOAC for a twice daily dose for with better outcomes?

[BobD Volunteer]

Healthy gums never bleed. Fact. See your hygienist regularly.

[DIB69 in reply to BobD]

I do, along with the hygienist every 6 months and my gums don't bleed at any other time except after I've take my Rivaroxaban in the evening. GP has agreed that's likely to be the problem.

[mjames1]

Yes. My theory is that the twice a day dosing results in more even drug delivery, i.e. less peaks. This is just an opinion and one anecdotal experience however, overall I've read better things about Apixiban vs Rivaroxaban. So if you don't mind twice a day dosage versus a single day, you might try switching.

Jim

[meadfoot]

Have a look on the NHS website it lists your issues on the side effects section. I have taken rivaroxaban for twelve years and bruise very easily. Try Apixaban if your symptoms are concerning you. Best wishes.

[Cavalierrubie]

With the nose bleeds as well, it has to be the anticoagulant. I would seriously consider changing. I find my GP is pretty useless with my AF. Trust your own instincts.

[mrdarcy1]

I take Apixaban for 7 years. My gums bled for about 6 years and my nose would bleed after blowing about the same as yourself.

I just kept going to see the hygienist every three months and I've noticed that after the last few visits no bleeding gums now.

I brush 2 times a day and now nothing, the nose still bleeds but it's only the once and then it stops so I'm not worried.

If it was a gush, I'd be different I think.

I wouldn't worry about it, just as the doctor isn't that worried.

Take care

[Jishuang44]

I have exactly the same with Rivaroxaban. My GP also isn’t concerned about it.

[Efka]

Husband had various side effects on Rivaroxaban so swapped for Apixaban. Not perfect but less side effects and less bleeding (he too had bleeding gums from Rivaroxaban). As also said above we both feel better with twice daily for “smoother” drug levels in the body. Medications are never easy, our physiology is all so individual.

[PAP48]

Morning DIB69, I had been on Rivaroxaban for about 6 years and started coughing blood, called Haemoptysis I think. I have bronchiectasis as well. My consultant changed me to Eliquis Apixaban and so far so good. I take 1 twice a day. It might be worth asking for a change of meds. Keep well.

[Ppiman]

Generic drugs are said to meet the exact same pharmacopoeial standards as the branded item, and, if there is any variance allowed in those standards, for example regarding fillers and binders, then the branded item can vary similarly. I worked for many years in the pharmaceutical industry and quality control standards were extraordinarily high and very expensively implemented.

I think many people on DOAC drugs like rivaroxaban have switched to apixaban and edoxaban since the NHS was able to source these at lower cost. Edoxaban has the added convenience of being once a day dosing, but some have written in here to suggest that twice daily dosing implies that the drug is cleared more quickly from the system and that this might be a benefit if ever a rare emergency occurred such as an internal haemorrhage.

Steve

[Vonnegut]

It gave me dreadful diarrhoea so I only took it for three days!!

[DIB69 in reply to Vonnegut]

Interesting, did you change to another?

[Vonnegut in reply to DIB69]

Apixaban, I think, which tended to lead to side effects at the other extreme! Since Flecainide has virtually put an end to episodes for me, I haven’t taken anticoagulants for some time and still here at 80! Of course, we are all different and hope you find what works for you.