Taking Eliquis and Metoprolol for A-fib: Concerned about side effects

Posted by damari @damari, May 25, 2020

Just diagnosed. Doctor prescribed Eliquis and Metoprolol. I was wondering what side effects common. I read there is a rare side effect of hair thinning for metoprolol. (take 25 mg 2x day) Also read that Eliquis can sometimes cause some stomach discomfort. (5 mg 2x day) Can either medications be taken in lesser amounts?

@elwood

Martin – just curious why you are on Warfin? The old gold standard but high maintenance. Xarelto and Eliquis so much easier to maintain – no dietary restrictions. Both now with meds to neutralize if needed. Sure you have good reasons. Would you share your thinking ?

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Hi @elwood. I get your question frequently — why do I stick with Warfarin as my anticoagulant? My answer is simple and to the point. There is a readily available antidote for Warfarin, but not for most other anticoagulants. Almost all hospitals (but with a few stupid exceptions) have the Warfarin antidote (a Vitamin K solution) on hand for use when it's needed. I have two personal experiences that drive my choice of Warfarin.

Three years ago, a neighbor on Warfarin fell off a ladder in his garage. I called 911 and the EMTs came and hauled him off to a hospital emergency room a mile away. An hour later, a medical helicopter picked him up and flew him to another hospital 20 miles away. Within another hour, he was pronounced dead from a hemorhaggic stroke — an uncontrolled brain bleed. The first hospital had no Warfarin antidote on hand. It's sister hospital 10 miles away could not rush it over either. So they called for the helicopter. The second hospital administered the proper antidote, but by that time, it was too late. I sang at his funeral a week later.

Another episode just last week involved a friend with A-fib who also takes an anticoagulant, but not Warfarin. I reminded him about my neighbor's fate. He called the doctor, asked about his medication, and was told it is a lot less trouble than Warfarin — lab tests, some diet restrictions, etc. In our pandemic environment, that's a bigger problem than before, risking the coronavirus to go to a medical laboratory for a periodic blood test required to remain safe under Warfarin. Even so, he is now looking for a doctor who will include Warfarin in his range of therapies for A-fib.

I remain upset about the death of my neighbor as a result of his treatment in a hospital that had no antidote for Warfarin on hand. As a result, my first question of doctors when I was rushed to the emergency room last Fall was "Do you have an antidote for Warfarin on hand?" They did. I resolved that I'll always ask that question when under treatment at any clinic or hospital, regardless of which anticoagulant I am taking at that time. I hope this gives you some options to consider and discuss with your doctors, hospital, and EMT services. Martin

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Afib raises risk of stroke, Eliquis the latest and considered most effective in prevention. Metoprotol slows heart rate in afib, does not correct afib. Makes people feel more comfortable with lower heart rate. I take both and metoprotol seems to be lowering my blood pressure too much. Taking a little less, though very careful to lower just alittle. I think Eliquis inflames my joints including my jaw though my cardiology person says inflammation of joints is not listed. There is alot not know about meds and the med people do not admit to much. In all fairness, those med heros are overwhelmed with covid19

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I have been on Metoprolol for about 13 years with no detectable side affects. My daughter had major side affects on it. I just went on Eliquis a week ago (A-Fib) so I don't know how they interact. My Metoprolol morning dosage doubled at the same time I was diagnoses with A-Fib. I was losing my hair before Metoprolol so I cannot address that. Good Luck !

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I'm on eliquis and metoprolol (12.5 mg am and 25mg pm) Read that side effects include hair thinning and can lead to dementia. Is this true? Rather scared. anybody have experience with either? I have noted hair shedding and wonder if long term cognition will be affected.

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@damari

I'm on eliquis and metoprolol (12.5 mg am and 25mg pm) Read that side effects include hair thinning and can lead to dementia. Is this true? Rather scared. anybody have experience with either? I have noted hair shedding and wonder if long term cognition will be affected.

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@damari, you'll notice that I moved your question to this existing discussion about side effects of eliquis and metoprolol. I saw on this webpage that hair thinning is listed as a rare side effect of metoprolol
– Metoprolol Succinate Side Effects by Likelihood and Severity https://www.webmd.com/drugs/2/drug-8814/metoprolol-succinate-oral/details/list-sideeffects

In this AARP article, beta-blockers are listed as a type of drug that can contribute to memory loss.
– These 10 Drugs Can Cause Memory Loss https://www.aarp.org/health/drugs-supplements/info-2017/caution-these-10-drugs-can-cause-memory-loss.html

If these potential side effects concern you, I highly recommend you talk with your cardiologist about your concern and discuss the pros and cons of the medication you're taking versus not taking them and talk about possible alternatives.

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I take Eliquis ( for over two years now) and have no stomach issues. Hope this helps.

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I had to come off metropolo. I had memory loss & confusion really bad & could not sleep.

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For me I found it slowed my heart down so when I biked or briskly walked I was out of breath and it took a while to get it caught up after sitting down.

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@basslakebabe19

I take Eliquis ( for over two years now) and have no stomach issues. Hope this helps.

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I take Eliquis also with no problems.

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@predictable

Hi @damari. Glad to see you back with us, especially since the two of us are A-fib victims. Your reliance on Metoprolol and Eliquis is not uncommon. The first of these and its side-effects are discussed on Mayoclinic.org. Check out https://mayocl.in/2LTLhoP as well as https://mayocl.in/3d0JLx7 for starters. Search separately there for Eliquis or its generic name apixaban with a focus on the "oral route" (as opposed to the intravenous route). On your question about lesser amounts, be advised that changing the dosages on both drugs is possible, but only in direct coordination with your specialist or primary care physician. A lot of patients cut their dosages without consultation, causing side effects that are hard to tolerate. In my case, my similar drugs are Carvedilol (25mg morning and evening) and Coumadin (5.0 and 7.5 mg on alternating days).

The side effects you mentioned are on public lists for your drugs. Can you raise your questions about them with your doctor(s) or your pharmacist before any changes are made in dosage? Martin

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Have had A-fib for 16 yrs. Am now on Xarelto, Verapamil for that and Irbesartan for blood pressure. Was on Metoprolol and noticed hair loss. Asked cardiologist and he said he'd never heard of that. I printed out some reports and showed them to him. I don't know if he believed me or not. Would like to hear from anyone who has had Watchman implant, which can eliminate need for blood thinner.

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@predictable

Hi @elwood. I get your question frequently — why do I stick with Warfarin as my anticoagulant? My answer is simple and to the point. There is a readily available antidote for Warfarin, but not for most other anticoagulants. Almost all hospitals (but with a few stupid exceptions) have the Warfarin antidote (a Vitamin K solution) on hand for use when it's needed. I have two personal experiences that drive my choice of Warfarin.

Three years ago, a neighbor on Warfarin fell off a ladder in his garage. I called 911 and the EMTs came and hauled him off to a hospital emergency room a mile away. An hour later, a medical helicopter picked him up and flew him to another hospital 20 miles away. Within another hour, he was pronounced dead from a hemorhaggic stroke — an uncontrolled brain bleed. The first hospital had no Warfarin antidote on hand. It's sister hospital 10 miles away could not rush it over either. So they called for the helicopter. The second hospital administered the proper antidote, but by that time, it was too late. I sang at his funeral a week later.

Another episode just last week involved a friend with A-fib who also takes an anticoagulant, but not Warfarin. I reminded him about my neighbor's fate. He called the doctor, asked about his medication, and was told it is a lot less trouble than Warfarin — lab tests, some diet restrictions, etc. In our pandemic environment, that's a bigger problem than before, risking the coronavirus to go to a medical laboratory for a periodic blood test required to remain safe under Warfarin. Even so, he is now looking for a doctor who will include Warfarin in his range of therapies for A-fib.

I remain upset about the death of my neighbor as a result of his treatment in a hospital that had no antidote for Warfarin on hand. As a result, my first question of doctors when I was rushed to the emergency room last Fall was "Do you have an antidote for Warfarin on hand?" They did. I resolved that I'll always ask that question when under treatment at any clinic or hospital, regardless of which anticoagulant I am taking at that time. I hope this gives you some options to consider and discuss with your doctors, hospital, and EMT services. Martin

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There are approved and available reversing agents for Eliquis and Xarelto since 2018.

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@darbybauer

There are approved and available reversing agents for Eliquis and Xarelto since 2018.

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@darbybauer, welcome. I noticed that you wished to post a URL to an article with your message. You will be able to add URLs to your posts in a few days. There is a brief period where new members can't post links. We do this to deter spammers and keep the community safe. Clearly the link you wanted to post are not spam, so allow me to post it here.

– FDA Clears First Reversal Agent for Rivaroxaban, Apixaban Anticoagulants https://www.dicardiology.com/article/fda-clears-first-reversal-agent-rivaroxaban-apixaban-anticoagulants

Darby, have you been prescribed an anticoagulant?

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