so today I had a phone call from anticoagulant nurse . So after just getting used to medication with side effects they now want to put me on apixoban instead of edoxaban which I was on . She explained that edoxaban everyone may be put on untill all information is back then they may change . So because of my weight age etc they don’t think the edoxaban is doing the job fully . Even thou I have not seen a consultant. So they want to change it . So what I want to know is is this normal .? How has it been for other people been put on apixoban . If only I could talk to an actual consultant and them do the test asked for eg echo cardio and 48 hr monitor to get full picture. Only just managed to get my anxiety under control now this is not going to help .
So confusing : so today I had a phone... - Atrial Fibrillati...
So confusing
Nothing to worry about in my opinion, Apixaban is a 12 hourly dose (twice daily) and Edoxaban is a 24 hourly dose (once daily). They may have decided Apixaban taken every 12 hours gives you better coverage and protection from stroke risk. Personally I would be more concerned if the change was the opposite way around and regard your change as a good change. It shows they are being diligent with you.
Here is a link to the Medications page where there are info sheets for both drugs.
heartrhythmalliance.org/afa...
Best wishes
Hi Anxious.
Sounds like a good move to me. First of all please note I'm not a doctor.
Apixaban has a much lower rate of internal bleeding than Edoxaban. They both are effective meds to take for reducing the risk of a stroke. I would suggest to just do it and you shouldn't even notice. In fact, if they put the Apixaban in an Edoxaban box without telling you, you wouldn't even know.
IMO an anticoagulant nurse probably knows more about it than a Cardio 🤣
As for your anxiety? Afib and anxiety are bedmates. There's no need to have any anxiety about this one. Give it the boot and kick it out of your front door now.
If only I could talk to an actual consultant and them do the test asked for eg echo cardio and 48 hr monitor to get full picture
Have asked your doctor to refer you? If not get on the phone in the morning and ask for an appointment to see the doctor. He/she can do this no worries.
Stop your worry - there's no need.
Paul
PS - I'm not a medic so my reply is not something to be taken as medical advice. Rather it's intended as something to discuss with your doctor.
Thank you that’s good advice . Think initially it’s all over whelming . I am waiting on appointment with consultant and when I was in hospital this is Wht the consultant said he was requesting these tests for me . I do feel a little better now with the advice given on here . I do realise it’s not medical advice but actual advice from the people who have been through it which I feel is more helpful thank you
Love your turn of phrase, Paul! My brother in law was on Edoxaban and died of bleed on the brain just before 82nd birthday. 2021. Can't ask my sister now what his diagnosis was. I was diagnosed in September 2019 and put on Apixaban after certain blood tests
Hi Camelia.
Sorry to hear about your brother in law. Apixaban certainly sounds the better option for you - if blood tests show this then it's a wise move.
Paul
Arrthymia nurses, anticoagulant nurses are part of a multidisciplinary team ( MDT). They will only make decisions they are cleared to make because of their extended training, and clear pathways will be followed as a result of the blood results, specific risks/benefits for you, that have almost certainly been discussed at an MDT meeting attended by doctors and nurses and technicians.Agree with Paulbounce that clinical nurse specialists are very knowledgeable in their specific field.
Anxious37 . Suggest to ask the doctor if a blood test to determine coagulation is needed.
Prothrombin time and partial thromboplastin time. Sometimes used for patients taking blood thinners. My cardiologist had me take them.
Reason £££.
I’d take Apixaban over Edoxaban any day.
@secondtry - Edoxaban used to be cheaper, don’t know current prices since we have had the generic Apixaban? Do you?
Your tag to secondtry didn’t work for some reason. I’ve not heard anything about the cost of Apixaban since the generics available at end of 2022. There were lots of posts here before that from members being asked to change to Edoxaban with the belief it was down to the cost of Eliquis (original brand of Apixaban).
Best wishes all
Isn't it strange how different opinions can be.Recently had Tia and senior Bats nurse told me less break through strokes on edoxaban.
hi. From what I’ve read , given the opportunity I think I would choose apixaban. I went with what the professionals offered me ( which was apixaban, )and just for reassurance I’ve never had a problem with it and I am pretty active on my bike and other activities. I also mind my grandchildren often so am often on the go. I work on the assumption that the medics and nurses work within the “ do no harm “ rule and have our best interests at heart . I understand that any changes are stressful though and understand your anxiety. There are lots of us on here on apixaban and hope that give you some reassurance
I agree with others that your GP can refer you to a cardiologist. But for such a (relatively) minor query it may take a long time to get an appointment. If you have a spare £250 you can book a private appointment and get answers to this and any other questions you might have. It could be the best money you have ever spent.
I'm on apaxiban,.no problems👍
I'm on apaxiban,.no problems👍
Stop worrying. Apixaban is considered to be the most effective NOAC by most . There was a push to move people off it onto Edoxaban about 18 months ago,which most of us fought off. The other way round would be more problematic for me and I insisted I stay on Apixaban There are no discernable 'side effects' for me and no one rlse I know on it.. I've been on it for years and consider it my best friend not my foe.
Hello there. I have been on Apixaban for almost 3 years and I am fine. I carry the wee card with the relevant information that you get inside the box in my purse so it's there every time I go out, but this is merely a precaution and it gives me peace of mind.
hi Anxious , I am the most angsty , neurotic AF person on the planet !! I have bad reaction to most of life but !!!!! Apixaban and I get on fine!!!! No side effects and I trust it. Have done for 5 years at least!!!!
Have no fear !! And try writing to your consultant’s secretary with your concerns or you could be hopeful and ask for an appointment ! All the best !!! L
Hi, you mentioned your weight - is that high or low? If high I suggest you start the diet yesterday as excess weight is one of the drivers of AF and leads to comorbidities such as high bp, cardiovascular disease etc. That’s the bad news. The good news is that you have the power! You can reduce your AF burden by adopting a healthier diet, exercising and losing weight - I’m not suggesting a jab because that doesn’t address the issue of lifestyle habits. Best wishes ❤️🩹
hi
I was swapped from edoxaban to Apixaban a couple of years ago after a blood test showed my kidneys were too efficient and as Apixaban is taken twice a day it stays more evenly in the blood throughout the day.
I questioned this with th EP and he said Apixaban was his preferred anticoagulant.
Hope that helps to put your mind at rest.
I’ve never heard of an anticoagulant nurse but the EP I saw privately after the lowest dose of beta blocker proved too much for me to take daily, told me that unless an episode of AF continued for a long time with a very high heart rate I was not at risk of stroke. I found they seemed to come either with constipation or the opposite problem! Be gentle with yourself- meditation, nice music, deep slow breathing, and to quote from The Hitch Hiker’s Guide to the Galaxy, “Don’t panic!”
Did he say what counts as ‘a long time’ and a ‘very high heart rate’ are? As AF varies so much how are you going to know what happens next time?
It was a long time ago now and I have virtually been AF free for some time thanks to the Flecainide, he prescribed for me initially to use as a PIP. I think he said I was only at risk of anything nasty if my heart rate was well over 100 for something like 12 hours or more which I never experienced. He did tell me to take one of my 1.25mg of Bisoprolol if my heart rate exceeded 140 twenty minutes after taking 100mg of Flecainide but it only was once! Good luck finding what works for you as we are all different.
Hi Anxious37, I follow your posts as we are of similar age and diagnosed around the same time. I also freaked out, and more so when they rapidly increased my Bisoporol as it ”did not do the job”. Mid December I was put on 10mg and asked to try it for 10 days, so over xmas, by the 30th ( a Monday, after pondering whether to go to A&E all weekend), I saw the GP, they did a ECG confirming I was above 130 HR in afib (which I knew from my Kardia and feeling crap). They called the hospital to see if they wanted to see me but got the advice to add Digoxin 125micrograms to the 10mg bisoporol. This has helped HR now at 80-90, but still in afib. So saw Cardiologist on the 3d who ( confirmed I am in persistent AF, I had a 14 day monitor), prescribed Apixaban 5mg x2 in prep for a cardioversion and referred me to an EP, who I saw today. Need to be on apixaban for four weeks before a cardioversion, so hope to have that done next month (but of course petrified, but calmed by reading this forum - and the EP was reassuring too).
Hi Purplekatt.
There's no need to worry about having a CV. You won't even know a thing about as you are totally under when they do it. I worried about having my first one - not anymore. It's great and you have a cuppa afterwards and some free biscuits.
It's walk in the park as you'll soon find out.
Paul
Hi Anxious37 I understand your concern, however like many others on this forum I have been on Apixaban for years without any issues. Of course, you should carry the card around however I also wear a small black silicone medical alert band when I'm out and about just in case of any accident, so that the paramedics will know immediately that I'm on an anticoagulant
Been on Edoxaban for years as I found it tricky to remember the twice daily Apixaban. Both are excellent for stroke prevention though it might come down to cost. Either one you are well covered.
I asked to be switched to apixaban because, the medical research that I found online seemed to indicate apixaban had the best safety profile (not that there was a big difference). I had originally been prescribed one of the DOACs that need only be taken once per day
I am not in a position to contradict any of the reasoning offered by your anticoagulation nurse for the switch of anticoagulant. However, when you next talk to your medical advisers it may be useful to have some knowledge of the changing NHS recommendations re choice of DOAC.
Firstly, several years ago, AF patients were routinely requested (and sometimes instructed) that their DOAC was being changed from apixaban to Edoxaban. Further investigation at that time found NHS advice to Clinical Commissioning Groups re this switch was solely because of the greater cost of Eliquis (apixaban).
Secondly, and more recently, patients on this Forum have been told they will be switched from Edoxaban to apixaban ie. the exact opposite of the previous recommendation. Now of course I smell a possible rat, and I wondered if this new switch was again based on cost. And I found this NHS advice, last updated Sept 2024. It's only a short article, and rewards reading ...
england.nhs.uk/long-read/co...
... and you will see in the table that a generic apixaban is now the equal lowest cost DOAC. And remember, the NHS recommendation is still to offer patients the cheapest DOAC to patients. (It's also interesting to note that Eliquis (the original patented apixaban) is shown as the most expensive DOAC!)
So, the possibility opens up that you could be being switched because of cost. However, the choice offered to an individual patient should be led by their medical history and unique circumstances, and in your case the medical reasons revealed by your nurse may well be the true reasons. But also, remember, treatment always requires the agreement of the patient to go forward. You have agency in this matter, and you definitely have the right to inquire further about the precise reasons for your suggested switch.
Good luck.
+1
I wish the generic apixaban were available in the USA, but apparently it will not be until 2028.
Im on Rivaroxaban. Has no side affects to my knowledge for me. Ask avout thar. Im 82 and weifh about 80kgBest regards from NZ
Colin
Hi, I think they are fairly similar but I read an interesting article that said in March 2022 the NHS were paid £14.8 million to reward GP's for prescribing Edoxaban. The deal was struck with the manufacturer Daiichi Sankyo. Always about money IMO.
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