Advantages of Eliquis or Xarelto over Coumadin?

Posted by lgerkin @lgerkin, Feb 3, 2021

Hi - I've been on Coumadin for 15 years and my PCP and hematologist suggested I might want to try the newer generation of blood thinners. So, I started taking Eliquis last week. I haven't noticed any changes but it does make me nervous that there is no way to know for sure if my INR is at the proper level. I realize that not having to get tested once a month is great in terms of convenience and I like that I don't have to avoid foods with Vitamin K. My question is - are there other benefits to taking Eliquis over Coumadin? The higher cost isn't too much of an issue since the copay isn't too bad with my insurance.

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@confederatesteel

I always take the Xarelto at dinner time and I sleep very well but the pain I've had in my joints is usually more in the morning so I've been looking into CBD oil to take the pain away and it can be used with the Xarelto I am the same problem that you guys have going on a vacation and having to get my blood checked so we have to find an answer somewhere

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I purchased some CBD oil for my grandson who has terrible pain in his legs from a horrific automobile accident in which his right leg was broken above the knee and both bones below the knee and his left leg below the knee. Even at such a young age, he has a lot of pain. The CBD oil did work for him. He won't use narcotic pain relievers at all. He occasionally smokes marijuana and swears that works best but doesn't want to get it prescribed to him. I know they do have it in pill form (the VA prescribes it for veterans with both PTSD and physical pain). I'm not sure if you could get that???

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@confederatesteel

I have had 2 episodes with PE. Now I am on Xarelto for life. Don't like that. I have muscle pain, joint pain, and tiredness. I could go on coumadin but am afraid of that too. I was on it about 10 years ago with no affects. Don't know what to do. I'm 64 and want to live normal.

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Don’t know if this will help you but over the past 18 months, I’ve passed 4 blood clots. The first one was a PE that started as a DVT in my right calf. I felt it go up my leg, get stuck in my thigh, went thru my armpit and into the heart and landed in my right lung as the PE. Two of the other three were just as serious, one almost completely blocked my stent and the other was so painful I ended up on the floor in agony.

I told you all that because I must take Estradiol, a female hormone which is known to make you throw clots, yet I’m not on any thinner. Twelve years ago, I had to have a procedure done because I had an Abdominal Aortic Aneurysm that was about to rupture and kill me. During the pre-op instructions, I had to stop two of my vitamins because they are natural blood thinners and make my blood to thin during the procedure and cause excessive bleeding. One was Vitamin E and the other was Beta Carotene. This is only a thought, but it you took both vitamins, you may be able to lower your other thinner medications so the side effects might decrease. Talk to your pharmacist and see what they say about taking the vitamins to reduce the dosage need for the medication you’re on. I take them daily and even tho I still throw clots, my Endocrinologist (hormone doctor) hasn’t prescribed a blood thinner drug. Once you’ve talked to the pharmacist, disgust it with your doctor.

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@brenda33540

I hear what you are saying!! My husband has no energy whatsoever, sleeps all the time. We have a doctor's appointment this morning so I want to discuss this with him. He has Afib so he will have to take a blood thinner for life too. Xarelto is definitely more convenient but there are a couple of things that concern me, the lethargy being one. Also I read that there is no antidote to internal bleeding with Xarelto or Eliquis (which he's allergic to) but there is for coumidin. If you end up with internal bleeding, the antidote could save your life. I'm not a doctor so don't quote me on that please. It's what I have read (and I've read scores of information on the internet!).
I hope you feel better. It might be worth seeing your doctor again just to be sure.

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To all those worried the new anticoagulants do not have an antidote to stop rare uncontrolled bleeding, the wait has been over for years!
If you are comfortable with coumadin and don't mind some of the mild inconveniences using this medication brings with it, then by all means stay on it! If it's working good for you, you trust it and your routine is not a problem, why fix what ain't broken? Vitamin K is the antidote.

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). There is peace of mind that all three of the newer, less complicated and highly effective blood thinners are protected by the same antidote.

A fourth, newer newer blood thinner — dabigatran (Pradaxa) — already has an approved antidote called idarucizumab (Praxbind).

For the first time in many, many years, those of us who need to be on anticoagulants, finally have a choice of blood thinners and the security and safety of proven antidotes.

(Information obtained from "Harvard Health Online," available through Harvard Medical School.
Similar information available at Mayo Clinic and Cleavland Clinic.

I am 71 with A-FIB. As soon as I was diagnosed, my cardiologist put me on Xarelto. The first week I noticed some tiredness, but that either stopped or I got use to it. A couple years later I had an ablation which helped a lot and went right back on the Xarelto with no side effects.

Wish everyone good luck finding the medication that works best for you. And please be cautious reading medical information on the Net. There ARE excellent, trustworthy sites available, but there are also a lot of quacks and hacks, so stay sharp and don't take ANYTHING without discussing it with your doctor first! I know you've heard this a million times, but just because it says "NATURAL," does NOT mean "HARMLESS!"

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@rubywitch67

To all those worried the new anticoagulants do not have an antidote to stop rare uncontrolled bleeding, the wait has been over for years!
If you are comfortable with coumadin and don't mind some of the mild inconveniences using this medication brings with it, then by all means stay on it! If it's working good for you, you trust it and your routine is not a problem, why fix what ain't broken? Vitamin K is the antidote.

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). There is peace of mind that all three of the newer, less complicated and highly effective blood thinners are protected by the same antidote.

A fourth, newer newer blood thinner — dabigatran (Pradaxa) — already has an approved antidote called idarucizumab (Praxbind).

For the first time in many, many years, those of us who need to be on anticoagulants, finally have a choice of blood thinners and the security and safety of proven antidotes.

(Information obtained from "Harvard Health Online," available through Harvard Medical School.
Similar information available at Mayo Clinic and Cleavland Clinic.

I am 71 with A-FIB. As soon as I was diagnosed, my cardiologist put me on Xarelto. The first week I noticed some tiredness, but that either stopped or I got use to it. A couple years later I had an ablation which helped a lot and went right back on the Xarelto with no side effects.

Wish everyone good luck finding the medication that works best for you. And please be cautious reading medical information on the Net. There ARE excellent, trustworthy sites available, but there are also a lot of quacks and hacks, so stay sharp and don't take ANYTHING without discussing it with your doctor first! I know you've heard this a million times, but just because it says "NATURAL," does NOT mean "HARMLESS!"

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Thank you for the info. Excellent summary!

I always tell people "dog poop is all natural but we don't put it in our mouths."

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Thank you so much for this interesting discussion which has been very helpful to me. I was on eliquis for a period of months over the past year and was recently told by my doctor that I can stop taking it. It was covered under my employer-sponsored insurance with a $25 co-pay. I am in the process of researching plans for Part D under Medicare, as I will retire in a few months. Though I'm not on a blood thinner now, it's possible that I would need to take one again and I wonder if anyone on this site knows of an effective and safe blood thinner that is reasonably priced. Neither Eliquis or Xarelto are covered well through part D without significantly higher co-pays and/or insurance premiums than what I pay through my job. Thank you.

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@rubywitch67

To all those worried the new anticoagulants do not have an antidote to stop rare uncontrolled bleeding, the wait has been over for years!
If you are comfortable with coumadin and don't mind some of the mild inconveniences using this medication brings with it, then by all means stay on it! If it's working good for you, you trust it and your routine is not a problem, why fix what ain't broken? Vitamin K is the antidote.

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). There is peace of mind that all three of the newer, less complicated and highly effective blood thinners are protected by the same antidote.

A fourth, newer newer blood thinner — dabigatran (Pradaxa) — already has an approved antidote called idarucizumab (Praxbind).

For the first time in many, many years, those of us who need to be on anticoagulants, finally have a choice of blood thinners and the security and safety of proven antidotes.

(Information obtained from "Harvard Health Online," available through Harvard Medical School.
Similar information available at Mayo Clinic and Cleavland Clinic.

I am 71 with A-FIB. As soon as I was diagnosed, my cardiologist put me on Xarelto. The first week I noticed some tiredness, but that either stopped or I got use to it. A couple years later I had an ablation which helped a lot and went right back on the Xarelto with no side effects.

Wish everyone good luck finding the medication that works best for you. And please be cautious reading medical information on the Net. There ARE excellent, trustworthy sites available, but there are also a lot of quacks and hacks, so stay sharp and don't take ANYTHING without discussing it with your doctor first! I know you've heard this a million times, but just because it says "NATURAL," does NOT mean "HARMLESS!"

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Once again, it is crucial to recognize outdated information presented here when the FDA has later acted to prevent severe consequences from misuse of approved medications. The antidotes for anticoagulants preventing blood clots from A-fib -- especially Coumadin, Andexxa, and Praxbind -- are vital examples.

The Harvard Health letter speaking highly of Andexxa was dated September 1, 2018; it reported initial approval of the drug on May 3, 2018. Two months later (December 31, 2018), the FDA modified its approval. It removed edoxaban (Savaysa) from the anticoagulants that Andexxa may be used against. The package insert and prescribing instructions also were modified (see <https://www.fda.gov/media/113279/download&gt;.

Praxbind, initially approved in October 2015, has undergone two important modifications, most recently on February 11, 2022, when the FDA approved special treatment for wrong-dose errors. The earlier change in April 2018 dealt with dosage and administration problems.

Take notice also that Andexxa and Praxbind are to be given only by intravenous injection. Coumadin (Warfarin) is neutralized by Vitamin K which can also be taken by mouth.

@rubywitch67 gives great advice above: "(D)on't take ANYTHING without discussing it with your doctor first!" They are up to date on safety of prescription drugs. I'll add my personal advice that, in getting treatment for bleeding injuries, ask the medical facility if they have the antidote on hand that you'll need to neutralize your chosen anticoagulant.

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@predictable

Once again, it is crucial to recognize outdated information presented here when the FDA has later acted to prevent severe consequences from misuse of approved medications. The antidotes for anticoagulants preventing blood clots from A-fib -- especially Coumadin, Andexxa, and Praxbind -- are vital examples.

The Harvard Health letter speaking highly of Andexxa was dated September 1, 2018; it reported initial approval of the drug on May 3, 2018. Two months later (December 31, 2018), the FDA modified its approval. It removed edoxaban (Savaysa) from the anticoagulants that Andexxa may be used against. The package insert and prescribing instructions also were modified (see <https://www.fda.gov/media/113279/download&gt;.

Praxbind, initially approved in October 2015, has undergone two important modifications, most recently on February 11, 2022, when the FDA approved special treatment for wrong-dose errors. The earlier change in April 2018 dealt with dosage and administration problems.

Take notice also that Andexxa and Praxbind are to be given only by intravenous injection. Coumadin (Warfarin) is neutralized by Vitamin K which can also be taken by mouth.

@rubywitch67 gives great advice above: "(D)on't take ANYTHING without discussing it with your doctor first!" They are up to date on safety of prescription drugs. I'll add my personal advice that, in getting treatment for bleeding injuries, ask the medical facility if they have the antidote on hand that you'll need to neutralize your chosen anticoagulant.

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The Internet link in my posting was corrupted, and I didn't catch it in time. Try this: https://www.fda.gov/media/113279/download.

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@predictable

Once again, it is crucial to recognize outdated information presented here when the FDA has later acted to prevent severe consequences from misuse of approved medications. The antidotes for anticoagulants preventing blood clots from A-fib -- especially Coumadin, Andexxa, and Praxbind -- are vital examples.

The Harvard Health letter speaking highly of Andexxa was dated September 1, 2018; it reported initial approval of the drug on May 3, 2018. Two months later (December 31, 2018), the FDA modified its approval. It removed edoxaban (Savaysa) from the anticoagulants that Andexxa may be used against. The package insert and prescribing instructions also were modified (see <https://www.fda.gov/media/113279/download&gt;.

Praxbind, initially approved in October 2015, has undergone two important modifications, most recently on February 11, 2022, when the FDA approved special treatment for wrong-dose errors. The earlier change in April 2018 dealt with dosage and administration problems.

Take notice also that Andexxa and Praxbind are to be given only by intravenous injection. Coumadin (Warfarin) is neutralized by Vitamin K which can also be taken by mouth.

@rubywitch67 gives great advice above: "(D)on't take ANYTHING without discussing it with your doctor first!" They are up to date on safety of prescription drugs. I'll add my personal advice that, in getting treatment for bleeding injuries, ask the medical facility if they have the antidote on hand that you'll need to neutralize your chosen anticoagulant.

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I honestly believed I was giving up to date information about the various anticoagulants and their antidotes currently on the market.
That I gave erroneous and out of date information has left me aghast as I assume the information I gather from the Mayo Clinic, The Clevland Clinic, The University of Washington and several other well know medical centers is as up to date as it can be.
I am very sorry offering advice I had no business doing. I thought I had done adequate research, but soon learned how badly I failed in that department. I have several medical issues that I often turn to Mayo for advice and support, and I hope I may continue to do that.
With sincere apologies
rubywitch

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@rubywitch67

I honestly believed I was giving up to date information about the various anticoagulants and their antidotes currently on the market.
That I gave erroneous and out of date information has left me aghast as I assume the information I gather from the Mayo Clinic, The Clevland Clinic, The University of Washington and several other well know medical centers is as up to date as it can be.
I am very sorry offering advice I had no business doing. I thought I had done adequate research, but soon learned how badly I failed in that department. I have several medical issues that I often turn to Mayo for advice and support, and I hope I may continue to do that.
With sincere apologies
rubywitch

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Don't blame yourself @rubywitch67. Harvard Health isn't very diligent in updating or throwing out information that has become obsolete, and their articles too often lack a clear indication of the date they were written. Your other sources -- Mayo Clinic, Cleveland Clinic, and University of Washington -- had no role in giving us current information on antidotes for "blood thinners" which are medically known as anticoagulants. We all can rely on Mayo, but in discussions on Mayo Connect with people anxious to find solutions to their own medical problems, we have to be alert to the possibility of being confronted with opinions, suspicions, old news. Stay with us and give us a hand on issues that are important to you. Martin

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