Eliquis and AFIB

Posted by lenmayo @lenmayo, Apr 18, 2024

Does anyone who has occasional AFIB not take Eliquis?

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Profile picture for lenmayo @lenmayo

@janicedStopping Eliquis should always be done under medical supervision, as abrupt discontinuation can increase the risk of blood clots, stroke, or other serious complications.
Key Considerations
Eliquis (apixaban) is an anticoagulant that prevents blood clots. Unlike some medications, it does not cause withdrawal symptoms, but stopping it suddenly can lead to a rapid return of clotting risk, potentially causing stroke, deep vein thrombosis (DVT), or pulmonary embolism (PE) within 24–48 hours of the last dose.
medxdrg.com
+1
Reasons for Stopping
Common reasons for discontinuing Eliquis include:
Temporary pause for surgery or medical procedures to reduce bleeding risk.
2
Resolved underlying conditions, such as a clotting risk that has been treated or is no longer present.
1
Adverse effects or bleeding complications, including internal or external bleeding.
1
Pregnancy or breastfeeding, where alternative anticoagulants may be safer.
1

3 Sources
Typical Process
Medical Assessment: Your doctor evaluates your risk of recurrent clots versus bleeding, considering factors like age, kidney function, and the reason for initial anticoagulation.
2
Temporary or Permanent Discontinuation: For short-term pauses, Eliquis is usually stopped 1–2 days before a procedure, with adjustments for kidney function or high-risk surgeries. For long-term discontinuation, the decision is individualized based on clotting risk and overall health.
3
Alternative Strategies: Your doctor may switch you to another anticoagulant, a lower dose, or non-medication approaches such as aspirin therapy or procedural interventions in select cases.
1
Monitoring: After stopping, follow-up appointments and monitoring for signs of new clots are essential to ensure safety.
2allas

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@lenmayo Apixaban, rivaroxaban, and dabigatran don't 'prevent' blood clots; they only slow the process, or retard it. Clots eventually do form as patients taking DOACs learn soon enough when they puncture their skin.

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Profile picture for gloaming @gloaming

@lenmayo Apixaban, rivaroxaban, and dabigatran don't 'prevent' blood clots; they only slow the process, or retard it. Clots eventually do form as patients taking DOACs learn soon enough when they puncture their skin.

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@gloaming
When people have AFIB blood clots in the left atrium appendage and can lead to a stroke. That is the primary reason for taking anticoagulants.

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Profile picture for judy3276 @judy3276

@justlucky You can go online and get a coupon. EVERYONE is eligible. https://www.eliquis.bmscustomerconnect.com/

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@judy3276 Incorrect, if you have part D of Medicare you can not use the coupon. If you have private or non Medicare D you can use it. Cost me $175 to learn this fact.

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Profile picture for highmtnview @highmtnview

@judy3276 Incorrect, if you have part D of Medicare you can not use the coupon. If you have private or non Medicare D you can use it. Cost me $175 to learn this fact.

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@highmtnview
Canadian pharmacy is a lot less expensive,
https://www.discountcanadadrugs.com/
Use referral code BER-LEO-540 for $20 off first order.

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Profile picture for windyshores @windyshores

I don't take any blood thinners at all.

Starting in 2015 I have had afib with very rapid heart rate, once a year, or even had a two year interval. This past year I had one episode in late August 2023, two in early October, and I just had one two nights ago, 4/16, with heart rate peaking around 200.

I am meeting with a new cardiologist at a teaching hospital and am going to ask about the "pill in a pocket" approach meaning short term anticoagulation. Some say a month, some say less time. And there is a lot of difference of opinion on how long it takes to form a clot.

When one of my episodes lasted 7 hours (usually they are 45 minutes to 2 1/2 hours) the hospital did an echocardiogram to check for clots.

A cardiologist pressured me to take a blood thinner back in 2015 and I declined. He later told he he agreed (much later) and that they were "probably" overmedicating people. Then again, my mother had continuous afib and had a stroke when off Coumadin for 5 days.

How often do you have afib?

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@windyshores I was on for 36 hours and off for 48 hours ish for the last month or two. Finally had an ablation yesterday. I am a runner and studies show runners (and other active sports I am sure) are at much lower risk of stroke because we run a lot more blood through the heart, so I avoided thinners as well. I am on a blood thinner now, started a week before the ablation and will take for 30 days, possibly 90 depending on how the next check goes. But after that, I am done.

My Dad was on a blood thinner as he had a couple of TSAs, so clearly he needed it, he was on Eliquis. But if you don't move much, I think thinners become more important.

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Profile picture for tanyawic @tanyawic

@windyshores I was on for 36 hours and off for 48 hours ish for the last month or two. Finally had an ablation yesterday. I am a runner and studies show runners (and other active sports I am sure) are at much lower risk of stroke because we run a lot more blood through the heart, so I avoided thinners as well. I am on a blood thinner now, started a week before the ablation and will take for 30 days, possibly 90 depending on how the next check goes. But after that, I am done.

My Dad was on a blood thinner as he had a couple of TSAs, so clearly he needed it, he was on Eliquis. But if you don't move much, I think thinners become more important.

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@tanyawic In fib the atria can't move the blood because they are contracting so fast (300-500) beats per minute and as a result the blood pools and coagulates in the left appendage forming clots. If the clot gets out of the atria stroke or heart attack can occur. If your RBC and Hct are high your blood is thicker to begin with.

It doesn't matter how much blood you're pumping. I am a cyclist and so is my EP. I wouldn't be taking a chance on this during the 90 days postablation. Personally I'd wear a monitor after the blanking period and see what's going on then make the decision to stop the thinner.

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Profile picture for tanyawic @tanyawic

@windyshores I was on for 36 hours and off for 48 hours ish for the last month or two. Finally had an ablation yesterday. I am a runner and studies show runners (and other active sports I am sure) are at much lower risk of stroke because we run a lot more blood through the heart, so I avoided thinners as well. I am on a blood thinner now, started a week before the ablation and will take for 30 days, possibly 90 depending on how the next check goes. But after that, I am done.

My Dad was on a blood thinner as he had a couple of TSAs, so clearly he needed it, he was on Eliquis. But if you don't move much, I think thinners become more important.

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@tanyawic An ablation damages tissues. It 'cauterizes' endothelial tissue lining the left atrium in the case of AF. Damaged tissues release cytokines which cause inflammation. Inflamed and damaged tissues are roughened and will have stuff flowing adjacent to them stick to them, things like blood cells and platelets. Platelets cause clots.

You WANT an anticoagulant issued to you with instructions to take it for at least three months post ablation. If a Watchman were implanted in the LAA at the same time, or later, you would WANT a DOAC to take for close to a year or until the confirmatory TEE shows no leakage.

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Profile picture for highmtnview @highmtnview

@judy3276 Incorrect, if you have part D of Medicare you can not use the coupon. If you have private or non Medicare D you can use it. Cost me $175 to learn this fact.

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@highmtnview have your dr connect you with a Canadian pharmacy. My Dr did that 4 years ago. I pay $70 for 3 months.

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Profile picture for lenmayo @lenmayo

@highmtnview
Canadian pharmacy is a lot less expensive,
https://www.discountcanadadrugs.com/
Use referral code BER-LEO-540 for $20 off first order.

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@lenmayo I pay $30 for a 90 day supply of Eliquis using that manufacturer's coupon. I'm eligible by virtue of my secondary insurance ( Medicare being primary) having a prescription drug plan ( non-governmental, private). Granted most people who take Eliquis ( or any other blood thinner are on a Medicare prescription drug plan and aren't eligible for this discount, so I'd agree that getting these drugs from a reputable Canadian pharmacy can save them significant $$$$$, but for those patients who have a private drug plan, this coupon might well provide them with better savings than they could get from a Canadian pharmacy.

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Profile picture for lenmayo @lenmayo

@highmtnview
Canadian pharmacy is a lot less expensive,
https://www.discountcanadadrugs.com/
Use referral code BER-LEO-540 for $20 off first order.

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@lenmayo, Thanks checked into the Canadian RXs, but needed at least 4 weeks to get it. So was forced to purchase 30 day supply through Part D. During this time I was finally able to get it through the VA. Now set up to receive in the mail, 90 day supply.

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