How do you decide when it's safe to stop taking Eliquis

Posted by domiha @domiha, Apr 6 7:27am

I am 75 years old with a lifelong history of panic disorder and ocd. A few years ago, I had what doctors later decided may have been a VERY brief TIA when for two or three minutes I was mixing up syllables in my speech. My cardiologist had me wear a monitor for 3 weeks and the EP said I had one episode of paroxysmal A-Fib and a couple of episodes of paroxysmal SVTs during that time. He put me on 5mg Eliquis twice a day and 50mg Flecainide once a day. Fast forward to now.... and I have changed cardiologists.... and never had any follow up with the EP. In October, my cardiologist implanted a loop recorder to check for A-Fib episodes as I never felt anything out of the ordinary. I saw the cardio last week and in the past six months I have had 0 A-Fib episodes. So he said he might take me off the Eliquis if I wanted, but leave me on the Flecainide, as he thought the Flecainide may be why I have experienced no further A-Fib episodes. Due to my obsessive worrying, I wasn't ready to come off the Eliquis as such fear has been instilled me about a possible stroke. So the doctor left me on the same dosage of both meds. My biggest problem with the Eliquis is that I have a lot of arthritis and bone and joint pain, but I can't take any anti-inflammatories, only Tylenol which does nothing for the chronic pain. I do also take turmeric (Bullet Proof brand, I consume one gummy per day) but I don't notice that it helps much with my pain. When I see the cardio in six months, I am thinking of asking to reduce my Eliquis to 2.5mg twice a day if I still have had no A-Fib episodes. But how does one decide it's okay to come off the Eliquis altogether? Would an EP know better than a cardiologist whether or not coming off the Eliquis is a safe idea at this point? I've noticed people mentioning muscle weakness from Eliquis. With my joint pain, I don't get a lot of exercise, and I can't say that is not the reason my muscles seem to have weakened a bit. Obviously, no one wants to have a stroke. But I also don't want to continue taking a medication that may not really be necessary because of fear and worry. Anyone else here who took blood thinner for A-Fib and then got off of it? Anyone else worry too much about consequences of stopping a med like Eliquis? How does one decide? Obviously, life has no guarantees, and I could be hit by a bus tomorrow and this would all be moot. Thoughts or comments?? I thank you in advance. Best wishes to all! Mike

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babheart | @babheart | Apr 8 10:59am

@domiha For what it’s worth- I had only one episode of afib a year until recently. I am symptomatic so knew each time. I’ve had several family members w strokes - happy to take Eliquis to avoid having to endure that. And taking turmeric or curcumin- talk to the doc and if they don’t talk w you/don’t have the time, find another who does. Good luck

rushhome | @rushhome | Apr 9 8:02am

I too am very symptomatic, can feel it right away. I had only the one occurrence over a year ago and my previous cardiologist allowed me to stop the metoprolol but not the eliquis. I meet a new cardio in May and have read several studies on using the Eliquis as a pill in the pocked alternative. Since I feel the afib, I could go on it for the 7 days or whatever is recommended after an attack. Truly hoping that will be a path forward.

Carinw | @karinw | Apr 9 8:36am

I have paroxysmal afib and am on Eliquis, Metoprolol . I asked my doctor if I should take flecinade when I have an episode. He said no. Does it help? Has anyone been able to stop an episode with this “pill in a pocket” treatment?

gloaming | @gloaming | Apr 9 10:53am

In reply to @karinw "I have paroxysmal afib and am on Eliquis, Metoprolol . I asked my doctor if I..." + (show)

@karinw A great many, yes. Some also stop an episode cold with an icepack on the back of their necks, or they plunge their heads into a bucket or (clean) sink of cold water. Or they do the Valvalva manoeuvre. Or they abstain from coffee, Some drink a liter of 'magnesium water' or take 200-400 mg of magnesium salt (threonate, malate, glycinate, citrate...whatever is on sale).

foundryrat743 | @foundryrat743 | Apr 10 5:06am

@domiha -Mike, I, like you, perhaps, sometimes panic! The first time I had a paroxysmal a-fib episode, where I felt my heart move, like a fish out if water, seemingly, I initially panicked. Then I checked my smart watch, that alerted me to the episode, and got an ecg reading, therefore recording the episode. Starting to feel faint, I woke my wife up, told her, briefly, and pushed the button on my smartwatch where it sent out the 911 call, and since the fire dept. ambulance is only a few blocks away, from my house, I soon heard the sirens. Anyway, after going through a ‘button’ monitor time, attached to my chest, for a couple weeks, where I had more a-fib episodes, I was diagnosed. Then, after a couple months, I had some troubling neurological symptoms! My new neurologist had an MRI taken, of my brain, and it revealed that I had had 2 lacunar strokes,- one old one, and a recent one. So, my neurologist called my cardiologist immediately, that afternoon. An appointment with a cardiologist was set up for me, the next morning. At that appointment, it was decided that I should be put on Eloquis! 3 months later, I am still on Eloquis! However, in the meantime, talking to my Cardiac Electrophysiologist, it was decided that I could benefit from having ‘The Watchman’ heart implant, which could reduce my chance of having further strokes, from small clots. So, a couple weeks ago, I had ‘The Watchman’ implanted, and the procedure went well! In a couple weeks, I will be checked, to make sure that the implant is secure. Should that go well, than they will take me off Eloquis, and put me on, I believe, Plavix, for about 6 months, then only baby aspirin the rest of my life! So, I believe that going off Eloquis, more than likely, is a tapered action, by the Doctor’s, for their patients.

jc76 | @jc76 | Apr 11 6:35am

In reply to @domiha "@kudzu I found this regarding Eliquis and curcumin: “ 1 Are there supplements I should avoid..." + (show)

@domiha
Good information. I recently had an appointment with pharmacist to go over all my prescriptions and supplements. She took me off the Turmeric and cumonoids.

I take Eliquis and probably 14 other medications so had a lot of supplements contradictions. I came off about 4 of my supplements based on contradictions' with my prescriptions.,

tsch | @tsch | Apr 11 7:47am

If you trust your heart doc, follow their advice. The risk of a stroke is significant if a person has afib.

domiha | @domiha | Apr 11 9:05am

In reply to @tsch "If you trust your heart doc, follow their advice. The risk of a stroke is significant..." + (show)

@tsch Since the loop recorder didn't pick up any AFib episodes over the past 5 or 6 months, heart doc was ready to take me off the Eliquis right away. Personally, I'd like more than a 6 month period, so I'm still taking it. Does six months without an AFib episode mean that I won't have anymore? I'd LOVE to not take it.... but I figure the drug is extra protection against a stroke IF I ever have another AFib episode. If I go back in six months and still have had no AFib episodes, I may ask him to switch from 5mg twice a day to 2.5 twice a day.

domiha | @domiha | Apr 11 9:08am

In reply to @jc76 "@domiha Good information. I recently had an appointment with pharmacist to go over all my prescriptions..." + (show)

@jc76 Good suggestion to ask the pharmacist which supplements I can safely take. Thanks!

domiha | @domiha | Apr 11 9:15am

In reply to @foundryrat743 "@domiha -Mike, I, like you, perhaps, sometimes panic! The first time I had a paroxysmal a-fib..." + (show)

@foundryrat743 Glad to hear that you were able to get the Watchman and that all went well. In my case, I had only one paroxysmal AFib when I wore a monitor for 3 weeks..... and I was immediately put on Eliquis by a Cardiac Electrophysiologist. Unlike you, I never noticed the AFib. I changed cardiologists about six months later and I never had a follow up with the EP. I've asked my current cardiologist about a referral to an EP, but he doesn't think it's necessary. I'm thinking EPs may be more knowledgeable about Eliquis, Flecainide, contraindications and the like. I tend to worry way too much about things that may never happen. For now, I'm staying on the Eliquis even though the cardiologist said he didn't think I really needed to continue it. Best wishes to you! I'm glad the Watchman has given you a good resolution to your situation.