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Is any one using Eliquis as a Pill in the Pocket?
I have read two studies now in cardiology journals that indicate the one size fits all prescribing of Eliquis is being questioned. The studies both conclude that PIP would be an effective way to treat some afib patients. Here is one of the articles. Has anyone gone this route with their physicians blessing? I have fatigue and leg pain with nose bleeds and my cardiologist still wants the 5mg twice daily regimen. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.121.053170
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IT should NOT BE used as a PIP. The whole rationale is that, as soon as you are in AF, you are at risk of a stroke. Some authorities say the first 12-24 hours are low risk, but I don't buy it. The problem lies in the poor flushing of the left atrial appendage due to the chaotic rhythm. If there is a chaotic rhythm, doesn't the poor flushing start at the same time? And if that poor flushing can lead to stale blood that wants to congeal, and then to clot, won't that clotting be dangerous if it dets dislodged when the heart lurches back into normal sinus rhythm? Yewbetcha!
The DOACs (direct acting oral anticoagulants) are meant for prophylaxis...meaning prevention. You can't prevent a stroke when it's already taking place! You want the prophylaxis in place before it is needed....right? So, once you get a diagnosis of AF, you should be placed on a DOAC immediately and take it continuously until you are deemed to be free of a risk of a stroke from AF...meaning the AF is strictly controlled. Since that risk is always there, most electrophysiologists and cardiologists will insist that you take a DOAC for the rest of your life. You can always return to AF, as happens in about 50% of all ablation cases. When you do, not if you do, when, you'd want your system to be infused with a DOAC.
What you can take for PIP are anti-arrhythmic drugs like Flecainide or diltiazem, or propafenone, which are relatively fast-acting (40 minutes to a couple of hours, typically). https://www.livingwithatrialfibrillation.com/2992/what-is-pill-in-the-pocket-for-atrial-fibrillation/
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3 ReactionsThis may be a silly question but exactly what is PIP?
"Pill in the Pocket". It's an expression for taking a medication only when needed in response to a particular event, not taken at regular intervals like most medication. An example of this would be an antiarrhythmic drug ( such as Flecanaide) taken by a person with paroxysmal A-fib, when he/she feels the symptoms of the A-fib occurring, in the hopes that the medication will stop the A-fib. I guess carrying the medication around in the pocket would make it available anytime the person feels the need for it.