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Advantages of Eliquis or Xarelto over Coumadin?
Heart Rhythm Conditions | Last Active: May 22, 2022 | Replies (49)Comment receiving replies
A friend takes Eliquis without any apparent side effects, after having had leg weakness while on Xarelto. The major concern with these drugs initially was that there were not readily available antidotes, while bleeding while on Coumarin could be stopped with vitamin K. But there are antidotes now, so that seems to make doctors more comfortable prescribing them and sparing the patients the frequent blood work, which became a bigger issue during lockdown and when people were reluctant to go to medical facilities unless really necessary. Here's a blurb from the Harvard Health newsletter.
"The wait is over for an antidote to stop rare uncontrolled bleeding linked to some newer blood thinners. The FDA approved andexanet alfa (AndexXa) on May 3, 2018. It's the first and only antidote to reverse bleeding in people taking apixaban (Eliquis), rivaroxaban (Xarelto), or edoxaban (Savaysa).
Another newer blood thinner — dabigatran (Pradaxa) — already has an approved antidote called idarucizumab (Praxbind). A dose of vitamin K is used to reverse the action of warfarin (Coumadin), a blood thinner used routinely for more than half a century and, until recently, the only such option for most people."
https://www.health.harvard.edu/diseases-and-conditions/more-antidotes-for-newer-blood-thinners
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I remain skeptical that antidotes are readily available to prevent bleeding when injuries occur to patients taking anticoagulants other than Coumadin (Warfarin). The positive Andexxa quote is four years old, and this antidote was submitted to further study and FDA review after that. I understand Praxbind was similarly placed under review after its original approval. Coumadin has a readily available and long-term antidote, but on three occasions it was not in stock at a clinic or urgent care facility when I came under treatment there. My advice to all is: Upon meeting a medical professional in a clinic, urgent care facility, or emergency room for treatment of a bleed, immediately ask them to assure you that they have the right antidote on hand for your variety of anticoagulant. A friend of mine on Coumadin died from a brain bleed when the hospital did not have the Vitamin K antidote in stock and they chose to air-transport him to a hospital 30 miles away too late.