Edoxaban change to apixaban

[Truffles2]

I have just been told I need to change my anticoagulant from edoxaban to either Rivaroxaban or apixaban something to do with my creatinine clearance . I didn’t really understand what the implications are of this Does anyone understand this and can explain. I’ve finally had my Cardiologist tell me to stop taking Bisoprolol, was only on 1.25 mg but I’ve been off it a week and feel soooo much better more my old self. But now I’m worried again about something that I don’t really understand

[MichaelJH Heart Star]

Edoxaban is the drug of choice for treating AF not because it is better but because it is approximately half the price. Creatinine clearance is a measure of renal function which can be adversely affected by Edoxaban in some people. This appears, to be the issue in your case. The good news is your GP is keeping a close eye on you.

[Truffles2 in reply to MichaelJH]

Thanks for your reply. It was the pharmacist that phoned me he didn’t really explain very well

[Truffles2 in reply to MichaelJH]

I’m trying to process this I’ve been on Edoxaban for the last 18months and they are only now changing it because of the creatinine clearance does that mean I have an issue with my kidneys?

[wilsond in reply to MichaelJH]

Why do you say Edoxaban is ' the drug of choice ' because it is ' better' as well as being cheaper?Apixaban is now off licence and so the cost is equivalent .

What citations can you give for the advantage of Edoxaban?

There has been a sudden surge towards switching people on Apixaban to Edoxaban in the UK,often without consultation!

Purely cost related.

Edoxaban comes with creatine issues,as well as digestive effects for some.

I spoke to my Electrophysiologist and he said he prefers Apixaban above all DOACs and has written to my GP that any change to AF medication is to be done by him

Proff Osman UHCW

[MichaelJH Heart Star in reply to wilsond]

If you read carefully I said "not because it is better but because it is approximately half the price"!, i.e. I never said it was better, The cost information came from the Portcullis Surgery (Ludlow) website where they say you can treat two patients with Edoxaban for the cost of treating one with Apixaban. As you would know cost is a major driving factor within the NHS which is why Atorvastatin and Simvastatin are tried before other statins which have less side effects although side effects of statins are exaggerated and over reported!

[wilsond in reply to MichaelJH]

Now got my reading glasses on,yes!I recognise the reality of striving for cost efficiency ,as long as patients do receive the most appropriate medication for their needs.

I didn't realise the statins were also prescribed on cost basis first ,co- incidentally I have recently been swopped from Atorvastatin to Rosuvastatin after several adverse liver function tests.

Thank you for the clarification

[Yellow26]

I must agree with everything Michael has said, I’ve been on Apixiban for years and have no problems whatsoever. Hope everything works out for you, but you must remember drugs can take a while for your body to get used to them.

[Knockmore]

Apixaban is I believe the drug of choice, the pharmacists may have other drivers regarding cost. It works well for me and I am also on a small dose bisoprolol without any issues. I think the iron count could jump around though if you are also on Febuxostat or similar and of course keep off grapefruit and similar citrus.

[Truffles2 in reply to Knockmore]

I’m fine with edoxaban but they changed it. Since they stopped my bisoprolol I feel so much better so much more energy. I know it works very well for some people and not for others. Sometimes I wish the doctors would listen more to their patients, have been saying I was not feeling well for so long and it was really getting me down to the point I was becoming depressed. I kept telling them I would rather have quality over quantity.

[AndySD]

Hi Truffles2Not sure if I can help but I can pass on experience I have had ...

2017 i had a stent fitted with multiple pulmonary embolism identified at the same time. All unexpected after maintaining gym level fitness for years.

I went onto apixiban for PE and bisoprolol for stent. 2 weeks ago my GP stopped bisoprolol. I feel like a switch has been flicked on ! More energy, less confused. Almost too hyper at times. All good though.

Apixiban has never caused me any obvious issues that I'm aware of. I've had gall bladder surgery and come off apixiban and gone back on again. So no issues with surgery involved.

The question was raised as to why I'm still on apixiban but my GP says best to be cautious as the PE was unexpected previously. He says nothing to lose taking apixiban.

Not sure if this helps ? I would say I don't notice any effects from taking it. On high dose initially I bruised a lot. But dosage was reduced. Good luck !

[Truffles2 in reply to AndySD]

Thank you for your reply. Stopping Bisoprolol has had the same effect on me too I no longer sleep in the chair as soon as I get home from work, more on the ball as well, can’t believe that for the year I’ve been on it I have felt awful. I had bypass surgery 6 months ago and was struggling to recover and suffered from constant fatigue. Was always being told you need to take it your only on a small dose etc etc kept being told give it time following surgery and they stop it and within 2 days was feeling so much better and finally felt some benefits from the bypass. Good to hear that apixaban has worked for you. I took my first one this morning. Just a bit worried that there might be a problem with my kidneys and that’s why they changed it. I have read on here that lots of people have been changes the other way apixaban to edoxoban but not the other way

[AndySD in reply to Truffles2]

Ah i see... the one thing I did wonder about is gout. It is odd but I've had about 4 attacks and also experienced poor circulation in my toes. No real connection to apixiban but elsewhere on the forum it was mentioned as connected . Doing the garden is also an event. The slightest scratch end up with blood dripping all over the place for a short time due to anticoagulant effect. I slso worry about dental treatment and bleeding. No excuse really. Just stop the apiciban the day before then start up again a day later. Meantime aspirin as a safety net ...

Hope this all helps. It's a good forum for info here.

Good luck again !

[Truffles2 in reply to AndySD]

Thank you AndySD. I will continue with the apixaban and they want me To have another blood test and a review in a month so will go with it

[Hidden in reply to Truffles2]

Hi trufflesJust reading your chat there I'm on apixaban and already have blood in the urine and it appeared in my mouth when I was washing up ,have you had any yet ?

[Truffles2 in reply to Hidden]

Hi Wattszer I have been reading about apixaban on Dr Google. I think if you have blood in your urine you should probably contact your doctor

[Hidden]

I've taken 3 tablets

[Truffles2 in reply to Hidden]

I’ve just taken my second no bleeding as yet