Taking Eliquis and Metoprolol for A-fib: Concerned about side effects

I take Eliquis ( for over two years now) and have no stomach issues. Hope this helps.

Hi @damari. Glad to see you back with us, especially since the two of us are A-fib victims. Your reliance on Metoprolol and Eliquis is not uncommon. The first of these and its side-effects are discussed on Mayoclinic.org. Check out https://mayocl.in/2LTLhoP as well as https://mayocl.in/3d0JLx7 for starters. Search separately there for Eliquis or its generic name apixaban with a focus on the "oral route" (as opposed to the intravenous route). On your question about lesser amounts, be advised that changing the dosages on both drugs is possible, but only in direct coordination with your specialist or primary care physician. A lot of patients cut their dosages without consultation, causing side effects that are hard to tolerate. In my case, my similar drugs are Carvedilol (25mg morning and evening) and Coumadin (5.0 and 7.5 mg on alternating days).

The side effects you mentioned are on public lists for your drugs. Can you raise your questions about them with your doctor(s) or your pharmacist before any changes are made in dosage? Martin

Hi @elwood. I get your question frequently -- why do I stick with Warfarin as my anticoagulant? My answer is simple and to the point. There is a readily available antidote for Warfarin, but not for most other anticoagulants. Almost all hospitals (but with a few stupid exceptions) have the Warfarin antidote (a Vitamin K solution) on hand for use when it's needed. I have two personal experiences that drive my choice of Warfarin.

Three years ago, a neighbor on Warfarin fell off a ladder in his garage. I called 911 and the EMTs came and hauled him off to a hospital emergency room a mile away. An hour later, a medical helicopter picked him up and flew him to another hospital 20 miles away. Within another hour, he was pronounced dead from a hemorhaggic stroke -- an uncontrolled brain bleed. The first hospital had no Warfarin antidote on hand. It's sister hospital 10 miles away could not rush it over either. So they called for the helicopter. The second hospital administered the proper antidote, but by that time, it was too late. I sang at his funeral a week later.

Another episode just last week involved a friend with A-fib who also takes an anticoagulant, but not Warfarin. I reminded him about my neighbor's fate. He called the doctor, asked about his medication, and was told it is a lot less trouble than Warfarin -- lab tests, some diet restrictions, etc. In our pandemic environment, that's a bigger problem than before, risking the coronavirus to go to a medical laboratory for a periodic blood test required to remain safe under Warfarin. Even so, he is now looking for a doctor who will include Warfarin in his range of therapies for A-fib.

I remain upset about the death of my neighbor as a result of his treatment in a hospital that had no antidote for Warfarin on hand. As a result, my first question of doctors when I was rushed to the emergency room last Fall was "Do you have an antidote for Warfarin on hand?" They did. I resolved that I'll always ask that question when under treatment at any clinic or hospital, regardless of which anticoagulant I am taking at that time. I hope this gives you some options to consider and discuss with your doctors, hospital, and EMT services. Martin

There are approved and available reversing agents for Eliquis and Xarelto since 2018.

For me I found it slowed my heart down so when I biked or briskly walked I was out of breath and it took a while to get it caught up after sitting down.

There are approved and available reversing agents for Eliquis and Xarelto since 2018.

It is important for Connect members to know a lot more about the reversing agent suggested by @darbybauer for serious bleeding when it is related to the anticoagulants Eliquis and Xarelto. The reversing agent is Andexxa, and it was indeed approved by the FDA in 2018. But Andexxa is not a pill to take with lunch. In the FDA news release announcing approval of Andexxa, you may find the following expert statement: "Andexxa's rapid reversal of the anticoagulating effects of rivaroxaban and apixaban will help clinicians treat life-threatening bleeds, where every minute counts."

Note the reference to the use by "clinicians treat(ing) life-threatening bleeds, where every minute counts." The crucial implications of that statement are 1) Andexxa is for intravenous application not an at-home antidote; 2) it is recommended for use by "clinicians" in a highly specialized treatment environment; 3) its use is recommended when a bleed is life-threatening. Be careful and be sure of the presence of a qualified medical professional when an antidote is needed for a bleed while taking Eliquis or Xarelto. Martin

Has ABLATION and a watchman device been considered? If not, why not?