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.

Interested in more discussions like this? Go to the Heart Rhythm Conditions group.

@lgerkin, I have no experience with taking blood thinners but I thought I would share the following articles that may provide more information for you while we wait for other members to share their experience. @predictable may also have some thoughts or information on blood thinners.

– (2019) Are the new blood thinners better than warfarin (Coumadin)?: https://www.health.harvard.edu/heart-health/are-the-new-blood-thinners-better-than-warfarin-coumadin
– (2017) Mayo Clinic Minute: Research shows newer blood thinners have lower risk of kidney function decline: https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-minute-research-shows-newer-blood-thinners-have-lower-risk-of-kidney-function-decline/

REPLY
@johnbishop

@lgerkin, I have no experience with taking blood thinners but I thought I would share the following articles that may provide more information for you while we wait for other members to share their experience. @predictable may also have some thoughts or information on blood thinners.

– (2019) Are the new blood thinners better than warfarin (Coumadin)?: https://www.health.harvard.edu/heart-health/are-the-new-blood-thinners-better-than-warfarin-coumadin
– (2017) Mayo Clinic Minute: Research shows newer blood thinners have lower risk of kidney function decline: https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-minute-research-shows-newer-blood-thinners-have-lower-risk-of-kidney-function-decline/

Jump to this post

Thank you for the info! I'll definitely check it out.

REPLY

Absolutely essential: read everything you can find about Elequis, especially the maker’s package insert. U think it comes with an FDA black box warning. It is not a drug to mess around with, but it looks to be better than Warfarin (BTW: Warfarin is diluted rat poison).

There is less risk of serious bleeding with Elequis & Xarelto. However, at least some of that evidence comes from meta-analysis which is not a very valid statistical procedure. The inventor of meta-analysis used to work for me, and he refused to use it because he didn’t trust it. There is a very costly way to stop internal bleeding from Elequis but not Xarelto. Do not do anything that might increase the risk of internal bleeding. That includes no aspirin, no NSAIDs. Blood has 2 different clotting systems, one for little cuts and bruises, and an additional system fro big cuts. The newer drugs only affect the big cut clotting system because that is what makes dangerous blood clots.

IF you get a cut that bleeds for more than 15 minutes, check with your MD right away because you may need a trip to the ER to stop it. Or you can do what the ER will charge $1,100 to do– slap Combat Gauze on it. I asked the ER MD what Combat Gauze was. He gave me some chemistry mumbo jumbo. He got a funny look on his face when I replied “That’s a napkin soaked in powdered kitty litter”. High quality kitty litter costs less that $1 a lb. Wait till you see what Combat Gauze costs, but I keep it handy, and it is a lot cheaper than the ER. I’ve only had to use it once at home, so far.

REPLY

I’ve recently been diagnosed with AFib and Dr has me on Eliquis (30 day free sample) and Metoprolol. Just checking drug prices for blood thinners took my breath away. Are these new drugs worth it or are there less expensive options that work just as well? I will be having discussion about this with cardiologist tomorrow, so looking for some input. Thanks

REPLY
@abbysmom

I’ve recently been diagnosed with AFib and Dr has me on Eliquis (30 day free sample) and Metoprolol. Just checking drug prices for blood thinners took my breath away. Are these new drugs worth it or are there less expensive options that work just as well? I will be having discussion about this with cardiologist tomorrow, so looking for some input. Thanks

Jump to this post

@abbysmom. I'm on Xeralto, same type of blood thinner. They are very expensive, even with insurance. Wafarin is cheaper but it interacts with vitamin k… No green leafy vegetables and other food high in this vitamin. Ieat alot of green vegetables so I refill it monthly so it's not such a sticker shock. Last year I had a Co pay of over 100 a month. I called the drug company for assistance but don't qualify. You can try and see if you have better luck. My cardiologist was able to give me some samples. That's another way. I do not have afib but I had a TIA so I have to take it so I don't have a stroke. Take care. Please share what your doctor say.

REPLY

Hi @abbysmom and welcome to Mayo Clinic Connect. So glad you joined the conversation. As you will see I paired your question with a discussion surrounding these drugs so that you can connect with members that are already talking about them.

Here is a website so that you can compare and contrast anticoagulants – https://www.goodrx.com/anticoagulants

I would definitely ask your cardiologist what he/she recommends. Have you researched one that you like over the other, whether price or side effects etc.?

REPLY

I was diagnosed yesterday with a large VTE in my left femoral vein. I’m in a rehab facility and have been on Zlovenox 40mg sc daily. Now they want me on Eliquis. Started first dose last night. I’m being worked up for petechiae, purpura, prolonged bleeding times, etc. My sister bled out on the OR table during her TAVR procedure because Eliquis was new and she received a dose the day before her duty. No antidote concerns me. I’m really concerned I could bleed out due to my blood disorder being worked up now by a “benign hematologist”. I had a Hematologist/Oncologist but MDKCV in NYC reviewed my bloodwork and determined in didn’t need MSKCC but did need Follow-up with the “benign hematologist” at Columbia University Medical Center. Any advice? They considered just giving me the Lovenox sq q12h vs daily? Might that ne s better option ?

REPLY
@cece1112

I was diagnosed yesterday with a large VTE in my left femoral vein. I’m in a rehab facility and have been on Zlovenox 40mg sc daily. Now they want me on Eliquis. Started first dose last night. I’m being worked up for petechiae, purpura, prolonged bleeding times, etc. My sister bled out on the OR table during her TAVR procedure because Eliquis was new and she received a dose the day before her duty. No antidote concerns me. I’m really concerned I could bleed out due to my blood disorder being worked up now by a “benign hematologist”. I had a Hematologist/Oncologist but MDKCV in NYC reviewed my bloodwork and determined in didn’t need MSKCC but did need Follow-up with the “benign hematologist” at Columbia University Medical Center. Any advice? They considered just giving me the Lovenox sq q12h vs daily? Might that ne s better option ?

Jump to this post

I’ve been on Ellquis for three years. Before any of my surgeries they told me to stop taking it 3 to 5 days before. Good luck with your surgery.

REPLY

My sister bled out on the OR table during a TAVR procedure. Eliquis was new and being heavily promoted. She’d received a dose the day before her surgery. Unnecessary death. Now they say stop your Eliquis 5 days before surgery. I’m not having surgery. Just in a Rehab facility.

REPLY
@cece1112

I was diagnosed yesterday with a large VTE in my left femoral vein. I’m in a rehab facility and have been on Zlovenox 40mg sc daily. Now they want me on Eliquis. Started first dose last night. I’m being worked up for petechiae, purpura, prolonged bleeding times, etc. My sister bled out on the OR table during her TAVR procedure because Eliquis was new and she received a dose the day before her duty. No antidote concerns me. I’m really concerned I could bleed out due to my blood disorder being worked up now by a “benign hematologist”. I had a Hematologist/Oncologist but MDKCV in NYC reviewed my bloodwork and determined in didn’t need MSKCC but did need Follow-up with the “benign hematologist” at Columbia University Medical Center. Any advice? They considered just giving me the Lovenox sq q12h vs daily? Might that ne s better option ?

Jump to this post

Hello @cece1112 and welcome to Mayo Clinic Connect. What a tragedy that your sister passed away. I am so very sorry for your loss. Your concerns coupled with your experience of losing your sister is so valid and understandable.

Can I ask how forthright you've been with these concerns with your hematologists in the past and if you have a plan to discuss this thoroughly at your follow-up?

REPLY

Had a Virtual Visit on Thursday with my new first Hematologist and my acute rehab MD. In l/o my TBI, balance disorder and frequent falls, the Heme doc was adamant I be taken off loading dose Eliquis immediately b/c risk for falls and cerebral bleed. Suggested best solution for me was to have an IVC Filter placed in IR. Placed on treatment dose of Enoxaparin 80mg vs prior dose of prophylactic 40 mg. I know one should be off Eliquis for 4-5 days before any invasive procedures or surgery. Rehab MD comes in yesterday morning and is all excited that the IR docs had a cancellation and they could’ve taken me yesterday morning = ONLY 24 hours post last dose of Eliquis. I politely declined stating I did not have a comfort level undergoing the IVC Filter placement with 50mg of loading dose Eliquis circulating in my bloodstream. Plus, I was just diagnosed with Von Willebrands disease and a Factor VIII deficiency. I’m not interested in the same fatal outcome my sister experienced. My rehab doc wasn’t happy. Had to cancel the IR time slot, the Ambulette, etc. My daughter is getting married on 9/9/22. I’m working my darndest to get there whether it’s using a walker or even a w:c if needed. Hoping not but I’ll be there by hook or by crook!

REPLY
@kb1942

Absolutely essential: read everything you can find about Elequis, especially the maker’s package insert. U think it comes with an FDA black box warning. It is not a drug to mess around with, but it looks to be better than Warfarin (BTW: Warfarin is diluted rat poison).

There is less risk of serious bleeding with Elequis & Xarelto. However, at least some of that evidence comes from meta-analysis which is not a very valid statistical procedure. The inventor of meta-analysis used to work for me, and he refused to use it because he didn’t trust it. There is a very costly way to stop internal bleeding from Elequis but not Xarelto. Do not do anything that might increase the risk of internal bleeding. That includes no aspirin, no NSAIDs. Blood has 2 different clotting systems, one for little cuts and bruises, and an additional system fro big cuts. The newer drugs only affect the big cut clotting system because that is what makes dangerous blood clots.

IF you get a cut that bleeds for more than 15 minutes, check with your MD right away because you may need a trip to the ER to stop it. Or you can do what the ER will charge $1,100 to do– slap Combat Gauze on it. I asked the ER MD what Combat Gauze was. He gave me some chemistry mumbo jumbo. He got a funny look on his face when I replied “That’s a napkin soaked in powdered kitty litter”. High quality kitty litter costs less that $1 a lb. Wait till you see what Combat Gauze costs, but I keep it handy, and it is a lot cheaper than the ER. I’ve only had to use it once at home, so far.

Jump to this post

I never heard of combat gauze

Is it something most people here know about and have used

Also I heard that when we reach age 80, Eliquis dosage can be lowered by half. Would like to hear from you all out there

REPLY
Please sign in or register to post a reply.
  Request Appointment