Cardiologist suggests I can stop taking Eliquis. Any thoughts?

Posted by dsisko @dsisko, Nov 18, 2020

I have been on Eliquis for about 2 years now for afib. I had a successful ablation at Mayo in Rochester in August 2019 and have had no afib incidents that I’m aware of since that time. I track my pulse with my iwatch and regularly track my blood pressure. Both are fine. I’ve been of the understanding that I need to take Eliquis for the rest of my life, however, my cardiologist in Florida has suggested that I could stop taking the Eliquis. Has anyone had a similar situation or has stopped Eliquis because of a successful ablation?

Hi @dsisko, I think it's great that you have been tracking your blood pressure and your pulse rate to keep an eye on any symptoms that may occur and what a relieving feeling to not have had afib since your ablation. I think raising the question of whether or not you should stop taking Eliquis is helping to advocate for yourself.
I'd like to invite @katydid77, @predictable, @elegantgem, @mayofeb2020, @cece55, @jimtazzis, and @rois4richo to the conversation.

@dsisko, do you have any trepidations or concerns with discontinuing the medicine with your physicians help?

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@amandaburnett

Hi @dsisko, I think it's great that you have been tracking your blood pressure and your pulse rate to keep an eye on any symptoms that may occur and what a relieving feeling to not have had afib since your ablation. I think raising the question of whether or not you should stop taking Eliquis is helping to advocate for yourself.
I'd like to invite @katydid77, @predictable, @elegantgem, @mayofeb2020, @cece55, @jimtazzis, and @rois4richo to the conversation.

@dsisko, do you have any trepidations or concerns with discontinuing the medicine with your physicians help?

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@dsisko @amandaburnett. I do not have afib, but I had a TIA in January so my cardiologist put me on Xeralto. I also had a loop recorder put in to monitor my HR. I asked to ba taken off Xeralto since so far there's no sign of afib, but he doesn't think it's a good idea. My children don't want me to be off this either, what if I have another TIA again, or worse, a stroke. My doctor did reduced the dosage from 20 mg daily to 15 mg.
My son in law, however, had afib. He had ablations done. A couple of years ago, my daughter found a doctor in Texas and when he examined my son in law, he found that there was a genetic factor. I don't know all the details. My son in law had an operation then, the problem was resolved and he's no longer on Eliquis. He's a very active person and cardiologist actually told him he could resume his exercise routine (rowing, and cycling) the week after the operation.
Blood thinner is new to me, I'm not happy with the side effects like random bruises, bleeding gum etc. I have hypertension and the fact that I have family history of strokes was enough for me to stay in, albeit reluctantly.
I'm waiting for the generic version of Eliquis or Xeralto as the costs these drugs are prohibitive.
I think if you want to discontinue with the drug, have a conversation with your doctor first. Mayo connect has been a God send for me as many of you have given me valuable insights. Maybe one of you who has stopped Eliquis can give you some information.
Be well.

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Hi, @dsisko. Interested and glad to hear that your afib was resolved by an ablation. Your continued use of Eliquis is surprising to me. I'm an afibber of several years and have been on the anticoagulant Coumadin ever since my afib diagnosis. My medical team tells me to plan on anticoagulant medication unless and until my afib is terminated, perhaps by ablation. I was offered Eliquis by my pharmacist but turned it down and chose to stay on Coumadin which has a common antidote readily available, while Eliquis has not. I prefer not to risk hemorrhage from an injury, which could happen if my anticoagulant kept my blood from clotting when I need that. My unusual predicament involves maintaining a balance in the blood's ability to clot, which I test regularly at the lab and which is monitored constantly by my pharmacist. Perhaps your blood's clotting index is pivotal in your decision on whether to stop taking Eliquis. Your medical team is the best source of guidance on this. They can give you good advice on whether the Eliquis poses a risk of hemorrhage that may no longer be necessary after your ablation. Hope you can have that conversation with your doctor(s) soon. Martin

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@amandaburnett

Hi @dsisko, I think it's great that you have been tracking your blood pressure and your pulse rate to keep an eye on any symptoms that may occur and what a relieving feeling to not have had afib since your ablation. I think raising the question of whether or not you should stop taking Eliquis is helping to advocate for yourself.
I'd like to invite @katydid77, @predictable, @elegantgem, @mayofeb2020, @cece55, @jimtazzis, and @rois4richo to the conversation.

@dsisko, do you have any trepidations or concerns with discontinuing the medicine with your physicians help?

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A couple of concerns. One is that I heard that in some covid cases, the body throws off large amounts of blood clots. I’m assuming that the Eliquis would be helpful if I got covid and clots. Another is that I am on a very low dose of tamoxifen which has a small risk of clots. Am concerned that going off the Eliquis could have a negative impact from the tamoxifen.

I had not taken any medications except short term until I started with Eliquis and losartan. I was adamantly against going on them at the time because of having generally good health and now that I was convinced to take them, I am concerned about going off of them. I feel a little crazy about the whole thing.

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@dsisko

A couple of concerns. One is that I heard that in some covid cases, the body throws off large amounts of blood clots. I’m assuming that the Eliquis would be helpful if I got covid and clots. Another is that I am on a very low dose of tamoxifen which has a small risk of clots. Am concerned that going off the Eliquis could have a negative impact from the tamoxifen.

I had not taken any medications except short term until I started with Eliquis and losartan. I was adamantly against going on them at the time because of having generally good health and now that I was convinced to take them, I am concerned about going off of them. I feel a little crazy about the whole thing.

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@dsisko. I'm on Losartan too for my hypertension. The covid/blood clot connection is another reason my children don't want me to go off blood thinner at this time. My son in law still has a small amount of Eliquis at home and is keeping them for this reason even though he's totally off this medication now.

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Thanks for the post; how many wires or transmitters were ablated & does your I-watch monitor the upper chambers of your heart ?

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@phillipdobrien

Thanks for the post; how many wires or transmitters were ablated & does your I-watch monitor the upper chambers of your heart ?

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My watch records an ECG when I self choose and monitors pulse continuously. My heart artery was ablated. I don’t know what you mean by ablating wires and transmitters

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@mayofeb2020

@dsisko @amandaburnett. I do not have afib, but I had a TIA in January so my cardiologist put me on Xeralto. I also had a loop recorder put in to monitor my HR. I asked to ba taken off Xeralto since so far there's no sign of afib, but he doesn't think it's a good idea. My children don't want me to be off this either, what if I have another TIA again, or worse, a stroke. My doctor did reduced the dosage from 20 mg daily to 15 mg.
My son in law, however, had afib. He had ablations done. A couple of years ago, my daughter found a doctor in Texas and when he examined my son in law, he found that there was a genetic factor. I don't know all the details. My son in law had an operation then, the problem was resolved and he's no longer on Eliquis. He's a very active person and cardiologist actually told him he could resume his exercise routine (rowing, and cycling) the week after the operation.
Blood thinner is new to me, I'm not happy with the side effects like random bruises, bleeding gum etc. I have hypertension and the fact that I have family history of strokes was enough for me to stay in, albeit reluctantly.
I'm waiting for the generic version of Eliquis or Xeralto as the costs these drugs are prohibitive.
I think if you want to discontinue with the drug, have a conversation with your doctor first. Mayo connect has been a God send for me as many of you have given me valuable insights. Maybe one of you who has stopped Eliquis can give you some information.
Be well.

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@mayofeb2020 Thanks so much for clarifying. I should have stated that I was including you because I remembered you discussing your son in law's condition. 🙂

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@dsisko

My watch records an ECG when I self choose and monitors pulse continuously. My heart artery was ablated. I don’t know what you mean by ablating wires and transmitters

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After my last knee replacement (around 2017), I was diagnosed with A-Flutter & warned it could turn into A-Fib within a few years & it did. A-Flutter was cured with a single ablation (one wire or transmitter). I was told A-Fib can be caused by one or more of 64 wires or transmitters being faulty & very difficult to correct since it's hard to tell which wire to ablate. My cardiologist was not in favor of electrophysiology but I would recommend looking into it. I believe it addresses all wires & finds the faulty one/s & ablates them while leaving all others in tact.

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@predictable

Hi, @dsisko. Interested and glad to hear that your afib was resolved by an ablation. Your continued use of Eliquis is surprising to me. I'm an afibber of several years and have been on the anticoagulant Coumadin ever since my afib diagnosis. My medical team tells me to plan on anticoagulant medication unless and until my afib is terminated, perhaps by ablation. I was offered Eliquis by my pharmacist but turned it down and chose to stay on Coumadin which has a common antidote readily available, while Eliquis has not. I prefer not to risk hemorrhage from an injury, which could happen if my anticoagulant kept my blood from clotting when I need that. My unusual predicament involves maintaining a balance in the blood's ability to clot, which I test regularly at the lab and which is monitored constantly by my pharmacist. Perhaps your blood's clotting index is pivotal in your decision on whether to stop taking Eliquis. Your medical team is the best source of guidance on this. They can give you good advice on whether the Eliquis poses a risk of hemorrhage that may no longer be necessary after your ablation. Hope you can have that conversation with your doctor(s) soon. Martin

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Hi Martin! In your reply to @dsisko, you stated "you preferred to stay on Coumadin because it has a common antidote whereas Eliquis does NOT." I have come to trust your experience and knowledge which is why your statement really took me by surprise!
There IS an antidote for both Xarelto and Eliquis called ANDEXXA and also one for Pradaxa called PRAXBIND. These antidotes are now as readily available as is Vitamin K, the antidote for Coumadin. When I had my ablation and the choice of anticoagulants was discussed, Coumadin was definitely at the bottom of my list. I did not want to have to go in every month for a coagulation test, a possible change in the dosage of my medication nor did I want to have to be extra careful of my diet……watching closely that I did not consume foods that contained high levels of Vitamin K. Being a vegetarian, this would have moved a great many fruits and vegetables to my "DO NOT EAT" list. Since you have been on Coumadin for a long time, you are aware of what needs to be avoided or eaten only in small and infrequent quantities, but if anyone is reading this who is unaware of the restrictions associated with Coumadin, I will list a few fruits and veggies that are high in Vitamin K. (I didn't look up any meats, but I believe most cuts of meat are quite low in Vitamin K)
Dark leafy greens (especially kale, Swiss chard and Endive) broccoli, squash, peppers, tomatoes, eggplant, carrots, onions, cauliflower, string beans, peas, soybeans, kidney beans, raspberries, strawberries, cantaloupe, plums, grapes, papaya and rhubarb. This is NOT the complete list of high Vitamin K foods and there are also a number of common spices, like sage and oregano, which are high in K.
While there are pros and cons for ALL anticoagulants, I chose one that would have the least impact on my daily life, not require monthly testing AND has an antidote. (It also had no side effects for me) My coagulation rate is checked at my regular 6 month cardio check ups and during the two years I've been on Xarelto, the results have been excellent.
I believe all the anticoagulant choices are good and safe and it comes down to personal preference. And you can always change if your choice is not working well for you.

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@rubywitch67

Hi Martin! In your reply to @dsisko, you stated "you preferred to stay on Coumadin because it has a common antidote whereas Eliquis does NOT." I have come to trust your experience and knowledge which is why your statement really took me by surprise!
There IS an antidote for both Xarelto and Eliquis called ANDEXXA and also one for Pradaxa called PRAXBIND. These antidotes are now as readily available as is Vitamin K, the antidote for Coumadin. When I had my ablation and the choice of anticoagulants was discussed, Coumadin was definitely at the bottom of my list. I did not want to have to go in every month for a coagulation test, a possible change in the dosage of my medication nor did I want to have to be extra careful of my diet……watching closely that I did not consume foods that contained high levels of Vitamin K. Being a vegetarian, this would have moved a great many fruits and vegetables to my "DO NOT EAT" list. Since you have been on Coumadin for a long time, you are aware of what needs to be avoided or eaten only in small and infrequent quantities, but if anyone is reading this who is unaware of the restrictions associated with Coumadin, I will list a few fruits and veggies that are high in Vitamin K. (I didn't look up any meats, but I believe most cuts of meat are quite low in Vitamin K)
Dark leafy greens (especially kale, Swiss chard and Endive) broccoli, squash, peppers, tomatoes, eggplant, carrots, onions, cauliflower, string beans, peas, soybeans, kidney beans, raspberries, strawberries, cantaloupe, plums, grapes, papaya and rhubarb. This is NOT the complete list of high Vitamin K foods and there are also a number of common spices, like sage and oregano, which are high in K.
While there are pros and cons for ALL anticoagulants, I chose one that would have the least impact on my daily life, not require monthly testing AND has an antidote. (It also had no side effects for me) My coagulation rate is checked at my regular 6 month cardio check ups and during the two years I've been on Xarelto, the results have been excellent.
I believe all the anticoagulant choices are good and safe and it comes down to personal preference. And you can always change if your choice is not working well for you.

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Hi, @rubywatch67. Two quick points in response before I run off and pick up our dinner at a drive-in and bring it home. First, I am familiar with Andexxa and Praxbind, but both of them encountered problems that delayed their release by the FDA for some time. If they are now fully approved and recommended by the FDA, that's good for everybody else to know. Second, I don't find Andexxa to be readily available. Last November, for example, I was in two hospitals in connection with a hypertension emergency, and as is my custom, I asked about the availability of Vitamin K and Andexxa. The Andexxa was not in the ready supply of either hospital. The Vitamin K solution was available in both. I am especially careful about this since my friend died of a hemorrhagic stroke four years ago because the hospital to which the ambulance took him following an accident had no Vitamin K on hand. I don't find it difficult to deal with foods (mostly vegetables) that provide Vitamin K in various amounts, because I have several years experience in consuming vegetables in fixed amounts and of regular types. Using a common diet, I achieve successful anticoagulation by minor modification of the doses of Vitamin K that I take. Your suggestion that patients needing anticoagulation medications are doomed to extreme complications if they choose Coumadin is overwrought. It is good, though, that they may find comfort in learning from you what questions they should ask when deciding on a medication. Martin

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@dsisko

My watch records an ECG when I self choose and monitors pulse continuously. My heart artery was ablated. I don’t know what you mean by ablating wires and transmitters

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Sorry for my terminology; I believe the wires in the heart's electrical system are called nodes & there are approximately 64 of them in the upper chambers of the heart. In the past it was difficult if not impossible to find & ablate the faulty one but I heard from a medical device rep that they now make a device that goes into all 64 nodes, discovers the faulty one & ablates only that one. I suggest you research electrophysiology if you still have issues. My own experience started with A-Flutter which required only one node being ablated but then turned to A-Fib. Good Luck !

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