Hi all, does anyone have advice as to how i can go about getting my apixaban as Eliquis? I keep getting switched to different 'makes' by my pharmacy and it makes me anxious and i think it matters which one/brand our body gets used to. I am hoping to get my GP to specify i stay with the same brand and that this be Eliquis. Has anyone had success with sorting this?
thanks
Broadly speaking it usually doesn't matter as they all contain the same active ingredients. The only difference is what else in the ingredients of the tablets ,but that is usually irrelevant unless something is added in the makeup of the medication that you are allergic to.
From my experience of other brands of less crucial medication, the variation in other ingredients can influence things like absorption rates. They are also 'generic' for a reason and cheaper because it is entirely possible that the quality of manufacture is not as reliable as the original pharmaceutical developed by a world leader.
I would never accept a generic apixaban unless I have no choice when it is so crucial to my survival.
My friend had a pharmaceutical company and supplies tablets internationally, he assured me there is no problem as they all pass very strict regulations to get the licences
I am sure the regulations are very strict but there is such a thing as human error in processes and unknown problems in drug reactions and side effects. I don't know why it is but I cannot tolerate at least one particular brand of Sotalol (beta blocker) which SHOULD be identical but on every occasion it has been given to me by the pharmacist I have found reaction. My conversation with the senior pharmacist led him to confirm that this was 'often the case' and he suggests it was the other bulking ingredients that were used and that not all generics were identical in all respects.
I get where you’re coming from. In Australia we have problems with HRT patches. I have had to accept several other brands and the changes between these are noticeable, unlike a tablet where the differences are not as clear. Some of my patches are made of a slightly rubber texture and others are like those plastic sheets you use for projector drawings and text. I assume the active ingredient is the same and the dose is the same, but I don’t believe they’re all as effective due to the different material used for the patch. Not sure if all that makes sense but I think it’s the same as your issue - but you can’t see it as clearly as I can with a patch and the different material used.
hi, yes, i do see what you are saying and thanks for your reply. its quite frustrating isnt it...that they cannot guarantee the same brand each time once we are 'used' to it. best wishes
Only for Diltiazem variants where it is essential to always have the same one if possible and the GP didn’t like it so we had a mini row over it. I think you might have to show that the generic versions don’t suit for some reason. I have not had a problem.
Thanks, yes... i gather the cost is going to be the issue...and i predict a 'mini row' too lol. Best wishes.
Can't you offer to pay the difference?
I like a certain brand of bisoprolol and my GP has specified the brand on my repeat prescription and my pharmacy always honour it. It’s worth asking - or write an email to your surgery asking, as obviously you can’t make an appointment for that request.
I think you will find Bisoprolol, unlike Eliquis, has several brands because it’s out of patent as it was developed in the 1970’s. Eliquis is still in patent in US but the UK High Court revoked the patent in 2022 in the UK which means our US friends don’t have the choice of a generic - hence the huge price difference.
A very strange thing happened with Xeralto in South Africa. In the middle of 2023 it became available as a 'generic' called Xorolo at less the half the price of the original. The tablets looked identical , the box the same- it even said manufactured by Bayer and the German address. Anyhow, although I was happily taking them, I read on this site that Eliquis was better for AF patients, so I got my Dr to prescribe that. However, it did not suit me, it gave me heart burn and significant hair loss - so back I went to Xorolo. It is still the same - same information, same packaging, but its price has now gone back to the original Xeralto price ! I don't know if the distributor made an error for a few months - but it makes you wonder what the mark-up is.! Anyhow, I've been back with it for several months and the heart burn has gone and the hair loss diminished, so everything has a price !
Certainly does. Different countries, different legal systems, different health systems have different protocols & pricing structures.
It is probably the fillers which vary and causes the problems so in UK you need your GP on your side but it’s often a battle as they are the jam in the sandwich of patient/management funding.
Why are you especially concerned? Have you had some kind of reaction? The same amount of drug is in all of them.
Just different manufacturers.
Some people might be sensitive to the filler ingredients but that's uncommon.
It really doesn't matter x
Agree 💯
Unless your GP has a very good medical reason to change you I doubt very much you will as the branded version Eliquis is going to be about times 3 the cost of Apixaban and the Pharmacy has a duty to obtain whatever is available at the least cost, they do that via an automated ordering system. With the NHS in the state it is in financially, GPs and Pharmacists are under tremendous pressure to keep costs to a minimum.
Cost of Apixaban to NHS is about £5/28 tablets. In the US/Canada the cost of 28 pack of Eliquis is approx $50.
Of course you could ask for a private prescription, which you would need to pay the GP for and then pay the pharmacist. I’ve done that for another medication for which I had a private prescription.
I just told the doctor I heard (on here) fillers used by Eliquis were different and might suit me better. I was better on Eliquis but I've since changed to riveroxaban anyway.
I am sensitive to fillers, amongst other things. I get horrendous migraine type headaches, nausea, vomiting and my normal day to day aches and pains increase. I can’t pinpoint exactly which fillers I react to apart from a couple, as sometimes it is a combination or quantity. When xarelto was changed to generic, I had increased daily headaches. I contacted gp explaining only change was going onto a generic instead of branded and could I stay on xarelto, not a generic. They changed it without a quibble.
I felt like that too when starting to receive non Eliquis. I had a temporary gastric issue at the same time as the change. I tried to get my pharmacy to request Eliquis permanently, but it didn't work. They explained the position re cost, and said the price difference is so high that the only way would be to buy it privately, working out at many hundreds of pounds a year. They also explained that asking to have a specific brand stipulated by the GP is futile - they can write it, but the pharmacy has to to stick by their NHS rules.
I also take Flecainide. I do think I feel better on one brand, and my pharmacy does request it for me from their 'wholesaler', and I wait an extra day to see if it comes in. Usually I am lucky, but not always, and it only works at all as 'my' brand doesn't cost more. It was this arrangement that led me to ask for the same when I stopped getting Eliquis, but Flecainide is a different financial scenario altogether. Sometimes I think we can get a little overly convinced we've found for ourselves the 'answer' which can possibly be just our going down a rabbit hole. As AFibbers, we tend to be very much 'informed patients', which is a very good thing - indeed, our condition absolutely requires us to be so - but there can be a downside to this. My experience of trying to get Eliquis is my example of that, I fretted needlessly over it for weeks, as the gastric issue was just coincidence, and it turned out that I had indeed gone down a rabbit hole. I hope you feel better about it all soon.
many thanks for sharing that with me. Best wishes.
You may be interested in this NHS advice about the procurement of DOACs. It gives a table with the relative costs of different DOACs. It currently shows eliquis as the most expensive, while generic apixaban is the equal cheapest. And the advice is that the first choice must be the cheapest appropriate DOAC available.
This is the "nocebo" effect where just thinking that a drug is a "knock off" generic can cause worse side effects. See:
newscientist.com/article/24...
A trial was carried out to test side effects, where one group was told they were given an expensive branded drug and another a cheap generic. The cheap generic group had twice the side effects of the branded. In fact they had both been given exactly the same saline spray!
Hello, I had a similar problem with my pharmacy too. I asked my GP to change my prescription to read the brand name first and drug name second . I didn’t have any problems after that. I am drug sensitive though so it was important for me not to be mixing up my meds. Worth asking your GP as the fillers are different in the different brands and in a lot of cases, they are what cause the issues. Good luck.
Unless there is some medical need for it to be a specific brand, then I doubt a GP will do that and as a tax payer, I wouldn't be happy if GPs prescribed a more expensive brand just because a patient preferred it without there being a medical reason. Obviously they and pharmacies have a duty to provide medication in the most cost effective way, without compromising someone's health. As someone I think has mentioned, there is the private prescription route.
I took Elquis for a number of years and have now been taking a brand called Sandoz since last year with no different effect.
my pharmacist knows I’m better with eliquis but unfortunately when the GPs send through the prescription without specifying they have to give cheapest one or whatever they have in stock. My pharmacist said if I ask my GP or whoever is in charge of medication to prescribe specifically eliquis he can always send that brand. Last time the prescription came through he rang the surgery and asked for them to change the brand himself.
Hope you get sorted.
thats interesting.... So your pharmacist rang the GP surgery ...? did they surgery just agree then?
I suppose they did because the eliquis was delivered the very next morning snd I gave the wrong ones back. A pity the GP surgery made that error as i believe once they leave the chemist they have to be specially disposed. (it wasn’t the doctor himself, but they have a new “pill” person there and I guess he/she just stated apixabsn despite all my repeat prescriptions say eliquis apixaban)
I agree. I get switched too. One brand makes me itch whilst the other does not. I am planning to ask my pharmacist!!
My pharmacist changed my Xarelto Rivaroxaban to a generic one a few months ago and they made me so nauseous l just couldn't function. It wasn't a 'sick' nausea feeling but a feeling that your whole body has been poisoned. I have a friend who works for a big pharmacist company who tell me that the difference between the contents of the 'proper' and generic versions could differ by up to 20%.
I'm now back on Xarelto and I've been fine.
No I don't get Eliquis either but the other brands don't seem to make any difference (not that I've noticed anyway).My friend is a chemist and owns a pharmaceutical company, he tells me they all pass strict regulations for licences and shouldn't make a difference which brand name is used.
hi it’s interesting that once a medication goes out of patent and becomes available in generic form that patients often seem to report issues with the medication. I believe the “active’ ingredients don’t/cannot be changed in a medication but often the binding/bulking and supposedly non-active ingredients of a tablet can be changed from brand to brand it could be this that is the problem. I personally have experienced this with my diabetic medication Metformin as it has been out of patent for years and I seem to have problems with gastric side effects every time my pharmacy changes the brand of the it for a period of time. The other issue here in the UK is that the NHS has a policy around the procurement and may dictate which brands NHS pharmacy dispensing can supply based on the cost medication
I was given Eliquis when I was first diagnosed with AF but since then have had a number of different brands, often Sandoz. I’ve noticed absolutely no difference so I would say don’t get hung up on a particular brand. The same thing happens with my other medications and I’ve never noticed any difference at all. To be fair, I don’t think the NHS should be expected to pay for a more expensive drug when it is on its knees already - although I do recognise that there are very rare cases where the brand makes a difference. Mostly any perceived difference is simply down to the nocebo effect, as stated above.
Not with Eelquis but my GP prescribes my painkiller by brand name because I have horrible reactions to the generic ones. I believe when they prescribe a specific brand they have to fill in a form to explain why, especially when it's more expensive but I don't see why your GP should refuse if you don't feel well on the cheaper brands.
Yes I had the problem. The only way I achieved getting Eliquis was getting my GP to state on the prescription "Eliquis Apixabain 5mg ... etc". Eliquis MUST be the first word. the pharmacy would not accept anything else. Not even "Apixaban 5mg Eliquis brand ...".
Yes different brands have the same apixaban in them, but the coating / other stuff is different and I felt unwell on another generic brand. I explained this to my GP and they changed the prescription - but only after saying they thought the pharmacist was unreasonable not accepting the previous prescription wording.
I think its something to do with pharmacists making more money out of prescribing cheap generics than the more expensive Eliquis.
All makes are identical so your fears really are ungrounded. The pharmacist has no way to order the branded form except on private prescription.
Your GP can prescribe the branded form, however if you speak to him or her if your fears.
Steve
My consultant prescribed Eliquis and told me ensure I received that and not generic due to headaches etc from generics. My surgery state Eliquis on my repeat prescriptions and I have no trouble receiving it from my pharmacy, although I did until the prescription stated Eliquis Apixaban.
my doctor specifically puts Xarelto as my medication otherwise I know whether I buy it through my insurance company or the They can pretty much give you what they want and they let you know it is the same medication and usually tell you what this one will look like if it’s a replacement
I was told the difference between the generic and the is mainly about timing. At least here in the US there is a specific amount of time where only the is available. No one else can make a etc. it has to do with patents etc.. many years ago I had one problem with an antibiotic that they replaced. It turned out. I was highly allergic to the coating and created a breathing swallowing issue somewhat like anaphylaxis it was very scary but nothing anyone could’ve foreseen. I think a lot of times brand names get put our heads from commercials and other advertising and that is what makes us nervous. The majority of my drugs are generic and I’ve never had issues. I don’t question if my doctor does prescribe. But I think usually the sales people that visit the doctors it has nothing to do with the drug. Talk to your doctor see what he can do. I know I just got sticker shock on my anticoagulant Xarelto. I had been receiving extra help and I am waiting for it to be reinstated. Meanwhile, it went from four dollars to $45 a month. Like you I don’t wish to try anything different because I have been from day one and I have had no side effects, etc. why I wouldn’t want to change.
Hopefully your doctor can write it out. Usually the pharmacy is following the instructions of your insurance if that’s how your meds get paid for besides from you I don’t know anything about your system for the most part.
I used to take Eliquis and then was switched to Appixaban which is the generic version, once it started being manufactured. They are the same, same makeup, didn't notice one difference. I believe its less expensive. But if you are receiving different makes, that call themselves these names, I am not sure what you are saying, I am sure there may be a difference.
you’ll be very luck if you have success. The main reason why our drugs are switched around so much is because at that particular time the pharmacist couldn’t get hold of your usual make. Mine are often changed.
My gp states Eliquis on my prescription so I always get it. It is interesting as I also take Digoxin and have been changed to a cheaper alternative and the amount of Digoxin in my blood is lower than it should be since taking the cheaper version.
Hello JFJ131
I was prescribed Eliquis by the Cardiologist. I subsequently was given the generic Apixaban which caused lots of stomach problems. I then requested from the GP that I needed Eliquis and this is always given to me. I still get the occasional stomach problem on Eliquis but take Omeprazole 20mg for 1 month then stop. That regime works for me. Good luck. Rosie
the only way is to ask your GP to prescribe as Eliquis . If a supply problem occurs sadly then the pharmacist can’t then change to generic brand so you could go without .
When I was diagnosed with Afib I was changed from Aspirin (which I had been taking for over 12 years after it brought me round from a Stroke in 2009) to Edoxaban (Anticoagulant) and after taking for 5 days I could not function at all. As I was going to Lanzarote in a week's time, I stopped Edoxaban and reverted to Aspirin. ( I spoke to my local chemist as I couldn't get a doctor's appointment and he gave his approval, but said see your doctor when you get back.) I enjoyed my holiday with no problems and went to see doctor. I asked why I could not stay on Aspirin. He said "it used to be recommended in the past but it isn't now". He prescribed Apixaban 5mg twice a day and said "give it a good go". I took it for 3 months and didn't feel well at all. I then had an excruciating pain in my right leg and couldn't sleep at all, even with strong painkillers. All my vital signs were fine and I was given 5 days wide spectrum antibiotics for a suspected bacterial infection, which helped a little but didn't cure problem.
My doctor sent the Acute Medical Team out to me, thinking a fresh pair of eyes was needed. They referred me to the DVT Clinic where after scanning my leg, I was diagnosed with Cellulitis and prescribed the same Antibiotic as my doctor, but for 7 days this time, and I was cured.
The problem seems to be Generic medication, as although it contains the same Active ingredients as Brand medication, there are Inactive ingredients which some people, unknowingly. be allergic to. This ranges from mild to extremely serious symptoms - where some people have died.
In my case I have been saved by Aspirin (which has no Inactive ingredients) but it does not agree with everyone. I have had my Pacemaker checked recently and two incidents of Afib in the last 12 months - 1 minute each. (The technician doing the check was surprised I was on Aspirin.) Hopefully, after I get the rest of my medication changed to BRAND this week, I won't qualify to post on this site!
Alixaban Brand - Eliquis vz Sandoz
anti coagulant brand switch
Experience with no medication!
Anticoagulants and hormone replacement therapy
