Stroke medication: Taking Eliquis to reduce risk of stroke

@elegantgem, Good questions about Eliquis and reducing stroke risk. I'd like to bring @yoanne @1943 @yorlik @cece55 @elizabeth1941 @phoenix1647 and @predictable into this discussion too. While we wait for others to chime in, you might also be interested in reading these discussions:

- Does anyone with AFIB NOT take blood thinners?: https://connect.mayoclinic.org/discussion/does-anyone-with-afib-not-take-blood-thinners/
- Questions about Eliquis: https://connect.mayoclinic.org/discussion/side-effects-of-eliquis/

Elegantgem, how long have you been on Eliquis? Might your doctor suggest an alternative?

@elegantgem. I had a TIA in January and had a loop recorder put in to detect afib. I was also put on Zarelto, a blood thinner like Eliquis as part of preventative measure for another stroke. So far no afib detected. I am also experiencing side effects like gum bleeding and body aches. Also the cost of these meds is prohibitive. I've emailed my cardiologist to see if there's an alternative or lower dose. He's reluctant to take me off.

If you still have aFib even after ablation, you should definitely be in a blood thinner. You are at risk for stroke. I have taken Warfarin for 10 yrs w no side affects. Coaquechek is an at home testing system.. just like a diabetic test. You put in results on app and Dr sees it. Warfarin is much less cost than newer DOAC’s.

Hi! This is CeCe 55 with a response. I was put on Eliquis after two AFIB events in 2017. I wear a Loop Recorder so that my cardiologist can monitor my irregular heart beat that I have had since birth. I went approximately one year without an event so thankfully he took me off of Eliquis and put me on one baby aspirin along with metoprolol 12.5 x 3 per day. I seem to react to medicines with more intensity than most and anything stronger that 12.5 metoprolol really brings my heart rate and blood pressure down very low. When I was on Eliquis, the only side effect that I had was terrible body aches. I told my cardiologist this and I have even been on Mayo Connect about this. No one else had experienced this. My pharmacist looked it up and sure enough it is a rare side effect. At the end of last year I had dental surgery and they had to stop Eliquis for a week. Within two days my body aches stopped. In January I was taken off it. I pray I never have to go back on again but it did it's job. Elegantgem...you are the first person who has also had the body aches. I feel your pain. Bless You.

Thanks for your help and forwarding my e-mail for response. I really appreciate it because I don't know what I want to do.. I have been on Eliqus for only 3 months. My doctor told me he does not prescribe Warfarin any longer as it has been his experience it causes too many problems for his patients. He has told me if I don't want to stay on Eliquis it is my decision. I think if I decide not to stay on it he will have me take aspirin.

I also have had body aches in my rib cage. I take Eliquis and also a statin drug. Statins are known to cause muscle pain but I was unaware that Eliquis could also. I don’t like to experiment to find out which drug is causing it.

@katydid77. I was put on Xeralto (the same category as Eliquis) and statin after my TIA.. I have neen having leg and back pain. I had tried statin years ago but couldn't tolerate it. I have convinced my doctor to let me stop statin for a while since my cholesterol wasn't high to start with. I want to know what's causing the pain. I have back pain before all these meds, but never that bad. I hope it's just the statin because i don't think he would let me go off Xeralto. I am very sensitive to medications. I want to be able to walk a few miles without pain as this is the only form of excercise that I can do.

Hi @elegantgem. Glad to have you join us here on Mayo Connect where we do just that because so many members want to help us think through our options for health improvements. I will give you a direct answer about Eliquis. I won't touch it. I've been in A-fib for 6 years -- maybe 30 years, since I've had an irregular pulse at least that long. When A-fib was diagnosed by my Primary Care Physician -- an internist not a cardiologist -- she let me check around. At the time, I had a half-dozen friends on Warfarin, so I followed their experience and joined the Coumadin crowd.

I've never regretted that choice, even though I had a small stroke two years ago from a blood clot that cut off oxygenated blood to a small section of my brain. It was the result of an unexpected rise in my INR followed by a reduction in my Warfarin dose which left me without enough protection from clotting in my left atrium. Even so, I plan to stay on Warfarin 37.5mg per week (spread over 7 days), and one of the reasons is that my regular lab tests every month or two keep me posted on how long it takes my blood to clot. I just had my August test and, as a result of a small rise in that time, we cut my dose by 1.0mg per week -- a tiny adjustment.

My main problem with Eliquis and Xarelto and Plavix is the uncertainty about whether the clinic or hospital I wind up in has an antidote. An antidote for the first two got FDA approval in 2018, but a year later -- a year after my stroke -- the antidote still wasn't available on the general market. There was a problem about the process for manufacturing it.

Availability of an antidote bears special importance to me. Three years ago, I found a neighbor on his garage floor with a head injury from falling off a ladder. I called 911 and got him to the hospital 2 miles away, but they didn't have the easy-to-acquire Vitamin K antidote for Warfarin, so they called for a helicopter to take him to a regional hospital but he didn't make it. I sang at his funeral. Antidote for Warfarin is readily available in a variety of forms, but for Eliquis and Xarelto, the Andexxa antidote is more difficult to find on the shelf of fewer emergency rooms.

My main concern though is that there are dozens of different A-fib heart problems, a half-dozen main groups of physicians who deal with it, and a variety of ways that A-fib presents itself to diagnosis. As such, it needs to be diagnosed and treated as a unique problem for an individual patient. There should be no "customary" or "typical" symptoms or remedies, because they are based on generalizations about a large population of patients. In your case, I hope you'll have the opportunity for a second opinion from a recognized expert in heart arrhythmia problems, followed by a team of medical professionals who can be counted on to advise you what's best in your personal situation. With that kind of advice, you may not need a lot of treatment in the years ahead. Let me know if I have left something out that bothers you a lot, and I'll respond quickly -- as will our other members on Mayo Connect. Martin

Thanks for your reply. I stopped the simvastatin for two weeks at which time I was not pain free but was much improved. My primary care doc changed my rx to Crestor which she said had fewer side effects. However, now the rib cage pain is back. I am wondering if cutting the dosage in half would ease the pain. Have you tried that? Please let us all know how you are doing and if you and your doctors have found a solution.

Thank you Martin for this information. I have never heard of an antidote. I will check this out more thoroughly. I am on 5mg of Eliquis taking two pills a day which I think is normal. Would taking less dosage of Eliquis make my problems less? What I mean is taking only one tablet a day make me feel less tired? I really didn't tell you all the issues i seem to have with Eliquis. Many mornings I wake up with headaches and my bones seem to bother me so much when getting up it takes time for me to put weight on my feet. My real thouhts are is Eliquis working against me more than helping me..