Blood Thinners–how soon do they act, how long to stay on them?

So nobody knows? How are we with occasional Afib to know how to best manage our blood clot concerns?

So I Called to Janssen Pharmaceuticals, Inc, maker of Xarelto: my question:

HOW FAST TO WORK? Answer: "Time is short."

WHAT??

I asked if she realized that "short" is a very relative term and means different things to different people! She apologized for the answer but that is it.

I was told if a doctor calls in and asks this question he/she is sent to a "Health care provider line, which has more answers!".

WHAT???? I let her know homy don't play that game...

I asked if this young lady worked for Janssen, the manufacturer of Xarelto, and she said yes. I asked if there might be any employee there who might answer this simple question, and she went in search of such a person...

She said there are charts that maybe a scientist might be able to decipher and then answer my question... But if you wait longer, I will search more and see if anyone here can decode these charts and pictures and tell us...

page 28 of 58: 2-4 hours after tablet intake = max concentration. Took nearly 30 minutes on phone but got it.

58 page doc being emailed to me... This nice young lady got the answer! I will share if that is appropriate or allowed?

NOW: what do we with Afib do with this info?

NEXT question obviously is: IF I begin an AFIB attack, how long before a clot might develop from it??

AS AFIB FOLKS WE NEED TO KNOW THIS STUFF!

Thank you so much for doing this. I'm guessing we'll never know from a layman's point of view how long it could take. Probably depends on lots of different things. I have to wonder if it really does any good to take it.

@yorlik..... I have AFIB and take Xarelto every day, so I can understand your questions and concerns. I have not done well on some of the medications prescribed and my AFIB is extremely symptomatic, so I will be having an ablation in 2 weeks. I strongly urge you to take your questions and concerns to your cardiologist.....the ONLY person who can give you the answers you are obviously desperately searching for. First you must understand that I am NOT a doctor and there are millions of us out here searching for ways to manage/control or "cure" our AFIB. It sounds to me like you have what is called "paroxysmal (intermittent) AF." This type of AFIB starts and stops on its own. It is the type of AFIB I have been diagnosed with. I can go all day with no "noticeable" AFIB, but after dinner, I will have an episode that can last for a few hours. I am having the ablation because I could not tolerate the side effects of antiarrhythmics. I don't know enough about AFIB to understand how you can go as long as a month with no symptoms...….that sounds wonderful to ME since I have episodes every day. I don't know which meds you have tried and which have failed, I don't know if your doctor would do an ablation without putting you on a trial of antiarrhythmics. I have not heard of ANY anticoagulant medication that can be used on a PRN (AS NEEDED) basis. I have given you no answers because I don't have any. I can only circle back to my original advice regarding talking about these issues with your cardiologist. You can discuss the "Link" device at that time, but it is MY UNDERSTANDING......(NOT FACT) that a Link is not implanted unless several ablations have failed. We ALL know how you feel and we ALL wish you the very best.

Thanks for your reply rubyw. Sorry to hear your afib is so often! My Dr also has discussed ablation if attacks continue.

You say "I strongly urge you to take your questions and concerns to your cardiologist…..the ONLY person who can give you the answers you are obviously desperately searching for." I respectfully disagree... Of course we need to have these type discussions with our cardiologist (and I have), but we also can research it on our own. Unfortunately most Dr.s after 20-30 years of doing the same rote thing over and over get in a rut like anyone else. They have their developed opinions based on facts but a lot of this is still opinions by a single Dr then. For instance, if you ask 10 cardiologists how long Xarelto takes to get to max strength in your blood after initial dose, I bet 9 will not know - they just don't NEED to know such details. They KNOW from experience and training that taking the blood thinner reduces the chances of a clot forming from our Afib and that is enough. Nothing against them, but they too are human.

As an engineer, I like to research things myself, understand how they work. Especially when it affects me and no one else seems to have the data. I now learned Xarelto takes only 2 hours to become very effective. For instance, how long does it take for a dangerous blood clot to form during Afib? Seems to me there should be a typical known (from imperical tests) time: IF that time is > 2 hours, then my taking Xarelto 24/7 is a waste and doing more harm than good to my body since I can tell when I go into Afib once every month or so (so far).

This is why I am still searching for the answer to that open question. If the answer is a blood clot can form in first 3 minutes of Afib attack, then so be it - gotta take Zarelto 24/7 to cover that one bout next month or the month after. If it takes 3 hours, I will discuss it with my cardiologist and determine if he can agree with my assessment to stop taking it until needed. Obviously this is not an option for anyone who cannot tell right away when they go into Afib.

I do a lot of my own research, too, which is why, when I see my cardiologist, I have 10 pages of questions! I wish I had time right now to go over all the good points you made in your post. The one thing I'm sure you've seen in your research is that millions of people have AFIB and don't know it. They have what, apparently, is called "silent" AFIB. They feel no symptoms at all. Their AFIB is discovered most often during their annual physical when they have an EKG. Those people have been at risk of having a stroke. And if I'm understanding you correctly, you seem to believe that you must be in actually AFIB before a stroke can happen and I am going to politely disagree with you on that. I have no proof to back that belief up and will definitely do some research on that. The fact remains that you DO have AFIB even though your episodes are infrequent. If I was lucky enough to only experience episodes as infrequently as you do, I personally would still want the protection of an anticoagulant 24/7. My reasoning for that is better safe than sorry. There IS a great deal they don't know about AFIB, but there is a lot they DO know. Until they have all the answers, I think those of us with AFIB need to do everything we can to protect ourselves. I hope you find the answers you need.

Great discussion. Thanks for taking time to give your thoughts and share what you have learned. Today I learned from that a cardiologist in Dayton, Oh tells his patients with Afib that the threat of a stroke from a blood clot is AFTER an Afib attack, not during it. Interesting and makes sense. Blood clot forms due to stagnant blood in upper chamber not moving thru [my new cow 29mm dia (biggest they make) valve]. Then, when Afib is over, ALL that blood in the top chamber is pushed thru and out to body - including any clots... So, a question: do blood thinners DESOLVE/MELT/DESTROY already made clots? NO but they do prevent them from getting larger. Or if a clot take more than 2-4 hours to develop as the blood thinner is efective by then. Why would I not want to take it 24/7, better safe than sorry? The side effects are more than I prefer to live with. Keep sharing what youu learn!

Can we paste link to data? If so, best found in answer to how long does a dangerous blood clot take to develop after afic episode:
https://www.healthtap.com/user_questions/230971-how-long-will-it-take-for-a-blood-clot-to-form-during-paroxysmal-atrial-fibrillation
Answers:

- days
- 48 hours
- shortest: maybe 5 hours

I will be talking to my cardiologist about stopping xeralto and use it only if I get an episode

Hi @mthurman and welcome to Connect. That must be frustrating to not get a respectful answer from your doctor when you asked him a question.

I wanted to introduce you to @trkuk @tresjur @ajm027 @pamelaann1 Mentors @predictable @cynaburst have all discussed clopidogrel (plavix) in the past and may be able to share their experiences with it.

Here is more information on clopidogrel: https://www.mayoclinic.org/drugs-supplements/clopidogrel-oral-route/description/drg-20063146

Back to you @mthurman, you mentioned you are feeling great, does that mean you have been without any side effects or symptoms since you had the stents put in?

<p>After stents I have been on clopidogrel for 13 months. In the beginning my cardiologist indicated I would have to stay on for one year. At my last visit one month ago I ask him how much longer to be on the clopidogrel. As he was walking out the door, WITHOUT LOOKING BACK, he angrily said "three years" and then walked out. I could not believe this. All I did was pleasently ask him a question. I have noticed on the internet, different cardiologist recommendations have been from 3 months to life time. Most have stated one year. I am feeling great and have since the beginning. Want to get off as soon as possible. Thanks for the response.</p>

Hi @mthurman,

You may notice that I moved your message and combined it with this existing discussion. I did this as I thought it would be beneficial for you to be introduced to other members who’ve discussed blood thinners.
If you click on VIEW & REPLY in your email notification, you will see the whole discussion and can join in, meet, and participate with other members talking about their or their loved ones' experiences.

I look forward to getting to know you better; may I ask why you had stents put in?