Stroke medication: Taking Eliquis to reduce risk of stroke

Posted by elegantgem @elegantgem, Aug 21, 2020

I am a 72 year old women who just recently had a heart ablation which was successful. Because of this my doctor feels I should be taking Eliquis since I probably still have afib. My problem is Eliquis makes me very tired and causes quite bad body aches for me. I think my risk of a stroke is 5%. My doctor still feels I should stay on Eliquis for a stroke. This is really the first major health issue I have ever had. I wanted to know if anyone has any advise they can give me. Thanks

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I apologize but I don’t know what you are saying when you said you tapered off Flecainide to PIP as I don’t know what PIP stands for. Flecainide is a potassium channel blocker used to treat arrhythmias and works by slowing nerve impulses in the heart. The Eliquis is an anticoagulant (DOAC) used to prevent blood clots forming in the heart because of AFIB activity so they are treating your AFIB by trying to control the rhythm and “thinning” the blood to prevent possible clots. It does sound like your arrhythmia is of a more serious sort than mine as I was told that treating the heart rhythm was optional-only if I found it disruptive as I am asymptomatic other than I feel it. It causes me no issues otherwise, except the threat of blood clots…
Nattokinase is extracted from Natto and is a concentrated form that does not have vitamin K or purine, both of which are in Natto. And unlike Nattokinase, Natto has a limited ability to dissolve blood clots as the amount of Nattokinase, which has the ability to dissolve clots, in Natto varies. So perhaps your EP (another term I am not familiar with) will have good advice on the matter.

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@jessica79

My son was incorrrctly diagnosed with afib and put on Eliquis. He had suffered a mild stroke about a month before and after being on Eliquis suffered a MAJOR hemorrhagic stroke leaving him with severe disability. He wasn’t given any antidote but was helicoptered to a major hospital where he underwent a craniotomy. He miraculously survived but was left with left side Hemiplegia. This was in 2017 and he’s still severely disabled but making slow progress.

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The more I read the more concerned I become about the Eliquis antidote, which apparently is AndexXa, approved by FDA in 2018 so it would not have been available when your son had his incident. From what I am seeing it is very expensive and not readily available. And I have also noticed not 100% success rate. A report I read said of the 150,000 hospital admissions attributed to factor Xa bleeding last year only 4,000 were treated with AndexXa. But I don’t know what the current status is. I have seen several posts of stories (not good ones) concerning the antidote but am uncertain as to how recent they are. I certainly hope your son’s recovery is complete and find the fact that the product was being strongly promoted when there was no antidote.

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@predictable

Hi, @harp23. Welcome to our ongoing discussions about anticoagulants (sometimes called "blood thinners") by patients exploring whether to start using them. Your condition seems very similar to mine over the last several years -- A-fib, small stroke, anticoagulant, concern about side effects. I have a more serious issue to raise presently. First, though, my A-fib is essentially asymptomatic, normal heart rate over the last 50 years or more (except for the short time after A-fib was diagnosed and a short time later when I suffered a small stroke), relatively good health otherwise for an 80-year-old man, taking a 5mg dose of anticoagulant every day, no upgraded treatment for my A-fib since the beginning.

My "more serious issue" is something you didn't mention -- antidotes for anticoagulants. For any one of those blood-thinners, an antidote has been developed -- sometimes more than one for an anticoagulant. The problems here are numerous, not singular. Here's why I feel that way: A friend from down the street fell off a step ladder in his garage just before I drove by and saw him in pain and blood from his head. I called 911, and the ambulance was there promptly and took him to the new hospital a mile away -- minutes away. In that emergency room with him was his wife who provided immediate information on his medications, which included an anticoagulant. But within a half-hour, he was on a helicopter for a 35-mile ride to a major hospital for treatment of a bleeding head wound. By the time his wife and children could catch up with him in the other hospital, he was in critical condition and died in their arms.

What happened? The crucial factor was that the first hospital he was taken to DID NOT HAVE AN ANTIDOTE IN STOCK for the anticoagulant that he had been on for several years. So he essentially bled to death.

That tragedy overwhelms me every time I go to a clinic or urgent care program or emergency room. So my first question at the outset of every one of those places is whether they have the most recent up-to-date antidote for my "blood thinner." Twice in the half-dozen times I had to ask that question, the answer I got was, "We'll get some brought in from another hospital right away." In both cases, I quickly left the facility and had family or friend take me to a clinic I knew I could trust. I always arrange for friends or family to be with me, right behind the 911 ambulance, for this purpose.

Whatever anticoagulant you are using, check several times a year to see what the latest and most effective antidote is for THAT SPECIFIC "blood thinner" and whether the antidote is available wherever you may need it. Take care and join me in making sure nobody else is told to take aspirin as an antidote for their anticoagulants. Martin

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I have been looking into the antidote issue and found the slow release of the only Eliquis antidote (AndexXa) and subsequent lack of availability (and high expense) very troubling. Do you have any updates in it? I have read some articles that mention some hospitals won’t even tell you if they have it. I will be checking my closest one tomorrow (I live in Maine) as well as a larger hospital within a 50 mile radius. Not seeing a lot of information about the success rate of the antidote but did notice some comments about side effects that were noteworthy.

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@harp, I am stunned to see a price of over $10,000 for four doses of AndexXa. To me, that makes it totally unavailable, just as it is when a hospital has none in stock or won't admit to having it. My personal policy for me is that I won't take an anticoagulant for which no antidoted is readily and normally available. I've had other reasons for declining Eliquis, but this information ices it for me. There are other anticoagulants with their own antidote available on the market. See if you can find a pharmacist who'll help you track them down. Martin

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