Any of you with PMR also have afib and on blood thinners?

Posted by vandyms1974 @vandyms1974, 2 days ago

I developed PMR and was prescribed Prednisone. That made a lot of difference. However, I later developed afib and was given Eliquis. Now it is harder to treat the PMR due to the bleeding potential while on Eliquis. I am currently on 1 to 1 &1/2 mg per day and it helps. However, we are considering the use of the Watchman heart implant to possibly get off the Eliquis after a few months. Anyone else been down this path? I am on the fence about the implant. Could it make the afib worse and an antiarrhythmic be needed? Lots of questions!

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

I don't have atrial fibrillation (AFib) but I'm on Eliquis/Apixaban for deep vein thrombosis with a 6" clot in my leg eight months ago. The clot occurred just after my first PMR flare. My doctor was aware from the beginning of an increased risk of clotting while on prednisone.

I started on 10mg Eliquis twice a day for 3mths, then 5mg Eliquis twice a day for 3mths, and am currently on a maintenance dose of 2.5mg Eliquis twice a day. What is it about taking Eliquis with prednisone that makes it harder to treat PMR?

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I have had AFib for 10 years and have been on
blood thinners all that time.
Currently am on 5 mgm eliquis 2x day; it had to be increased from 2.5 mgm because of weight gain from Prednisone.
I was diagnosed with pmr 9 months ago and am currently on 6 mgm Prednisone a day.
Not an easy path to tread. You have to be super vigilant regarding bleeding and try not to worry too much. Right!!

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I didn't have a-fib but I had other cardiac arrhythmias while on Prednisone. I didn't get on blood thinners until I had multiple, bilateral and extensive pulmonary embolisms of "unknown etiology." After spending a a couple of days in intensive care, I eventually went home on "warfarin for life." My cardiac abnormalities probably stemmed from elevated blood pressure in excess of 200/100. I developed left ventricular hypertrophy (LVH) from high blood pressure.. A cardiologist started three blood pressure medications. I didn't have much hope that I would ever be able to stop the blood pressure medications and warfarin. Being short of breath with minimal exertion all the time was the worst of it.

Things started to improve after I was able to discontinue Prednisone. At first, I was dizzy all the time and I had to be careful so I wouldn't faint. My blood pressure was getting too low and I was diagnosed with orthostatic hypotension.
https://www.mayoclinic.org/diseases-conditions/orthostatic-hypotension/symptoms-causes/syc-20352548
My blood pressure medications were stopped one by one. Now my blood pressure is a healthy 110/70 with no blood pressure medications. I have bradycardia but that was normal for me when I didn't take prednisone.

After 10+ years on warfarin, the anticoagulation clinic offered Eliquis so I wouldn't need to have my INR checked so often. I was reevaluated for my heart health. When it was learned that I was no longer on Prednisone, it was decided that I no longer needed any blood thinner. Now I'm off warfarin and all my cardiac medications including Atorvastatin in addition to being off prednisone.

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I have AFIb and PMR. Trying to wean down the prednisone, currently at 9mg going to 8.5 today and reducing by 1/2 mg a month. It’s such a slow process. But have tried 1 mg a month and always flare at about 5. Trying a slower taper. My doc has never mentioned the danger of afib and taking Eliquis with prednisone. I learn more from all of you. Now I am worried!!!!!

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@tapamil65

I have AFIb and PMR. Trying to wean down the prednisone, currently at 9mg going to 8.5 today and reducing by 1/2 mg a month. It’s such a slow process. But have tried 1 mg a month and always flare at about 5. Trying a slower taper. My doc has never mentioned the danger of afib and taking Eliquis with prednisone. I learn more from all of you. Now I am worried!!!!!

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Don't obsess about it. May never happen.

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@tapamil65

I have AFIb and PMR. Trying to wean down the prednisone, currently at 9mg going to 8.5 today and reducing by 1/2 mg a month. It’s such a slow process. But have tried 1 mg a month and always flare at about 5. Trying a slower taper. My doc has never mentioned the danger of afib and taking Eliquis with prednisone. I learn more from all of you. Now I am worried!!!!!

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I'm on Eliquis and prednisone together after a DVT (thrombosis) 8mths ago. When I had no choice but to start on a blood thinner, my doctor mentioned a problem with taking the blood thinner Warfarin with prednisone. If we have to take a blood thinner with prednisone, Eliquis is apparently the better one to take. They work differently.

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@megz

I'm on Eliquis and prednisone together after a DVT (thrombosis) 8mths ago. When I had no choice but to start on a blood thinner, my doctor mentioned a problem with taking the blood thinner Warfarin with prednisone. If we have to take a blood thinner with prednisone, Eliquis is apparently the better one to take. They work differently.

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Warfarin interacts with many medications including prednisone. Interactions are a two-way street. You are correct, warfarin shouldn't be used with prednisone for some of the same reasons that NSAIDs shouldn't be used with prednisone.
https://www.drugs.com/drug-interactions/coumadin-with-prednisone-2311-1529-1936-0.html?professional=1
In my opinion, I would never have needed warfarin except for being on prednisone. I'm currently off prednisone and now my doctor says I no longer need warfarin. Apparently, my risk of having another massive pulmonary embolism (PE) is much less.

The intensive care doctors were so incredulous when they saw my PE on the chest CT. The only risk factor I had was prednisone. My cardiac arrhythmias and hypertension were also blamed on prednisone.

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@dadcue

Warfarin interacts with many medications including prednisone. Interactions are a two-way street. You are correct, warfarin shouldn't be used with prednisone for some of the same reasons that NSAIDs shouldn't be used with prednisone.
https://www.drugs.com/drug-interactions/coumadin-with-prednisone-2311-1529-1936-0.html?professional=1
In my opinion, I would never have needed warfarin except for being on prednisone. I'm currently off prednisone and now my doctor says I no longer need warfarin. Apparently, my risk of having another massive pulmonary embolism (PE) is much less.

The intensive care doctors were so incredulous when they saw my PE on the chest CT. The only risk factor I had was prednisone. My cardiac arrhythmias and hypertension were also blamed on prednisone.

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You do blame so many things on prednisone, and in your case, that may be true. In my case, I had a history of DVT before PMR, so that (and latent TB) were listed as higher risks on my medical record when I started prednisone.

I've been on warfarin before, a long time ago. I expect I'll need to stay on Apixaban for at least 12 months as it has a higher risk of rebound clotting when it is stopped than Warfarin did. That consideration and risk doesn't have anything to do with prednisone. I'll continue to discuss all my health risks and how they may be best mitigated regularly with my doctor.

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@megz

You do blame so many things on prednisone, and in your case, that may be true. In my case, I had a history of DVT before PMR, so that (and latent TB) were listed as higher risks on my medical record when I started prednisone.

I've been on warfarin before, a long time ago. I expect I'll need to stay on Apixaban for at least 12 months as it has a higher risk of rebound clotting when it is stopped than Warfarin did. That consideration and risk doesn't have anything to do with prednisone. I'll continue to discuss all my health risks and how they may be best mitigated regularly with my doctor.

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I don't really blame prednisone for anything. I needed daily prednisone for a very long time. I understand how hard it is to blame the medication that works so well for debilitating pain.

On the other hand, I developed many additional medical problems while on "long term" prednisone for PMR. Most of my additional medical problems happened after I took Prednisone daily for more than a couple of years.

I took prednisone on a "short term" basis for many years for some other autoimmune conditions before PMR was diagnosed. I didn't ever have problems tapering off prednisone. Except for early onset cataract formation, I can't say prednisone caused any problems . I took high doses of prednisone frequently but only a month or two before tapering off.

I try to differentiate between "short term use" and "long term use" of prednisone. I didn't realize what all long term prednisone was doing to me until I was able to taper off prednisone after 12 years of PMR. I also got a warning from an incredible person on the internet who seemed to understand the unintended consequences of long term prednisone use.
https://www.healingwell.com/community/default.aspx?f=16&m=4073463
The conversation in the above link was when I started to look at prednisone differently. I really wish that I would have had this conversation sooner than I did.

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I developed A-Fib long before PMR/Pred. It was suggested I get a sleep study done. Turned out I had severe sleep apnea and since using a C-PAP I no longer have A-Fib and am off blood thinners! I'm so glad I took the sleep study advice!

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