NOACs

Seeking information from all the wise people here. Dabigatran, rivaroxaban and apixaban are all licensed in the UK for the management of AF. Are there differences between them? Is any one better than another?

I ask for my sister who has just had her AF officially diagnosed and given apixaban. For us AF is familial I think - I had it until my ablation, my mother and brother had it, and now my sister.

Gill

Hi Gill,

Natale & Shannon seem to like ELIQUIS (apixaban)‎. No personal experience, but from what I gather - it has a shorter half life. One issue with the NOAC's is a lack of an antidote, so a shorter half life is a benefit if there is a bleed.

Cheers,

George

Hi Gill - I believe Shannon posted something to the effect that overall performance/efficacy was found to be better with Eliquis.

As George mentions, since there is no antidote yet, it seems logical and better to have a 'lesser' dose taken twice a day rather than one larger dose that lasts 24 hours.

I've been on Eliquis for a couple years and fortunately had the dose reduced to the half dose or 2.5 mg twice a day.
Unfortunately, for me, it is not without side effects.

Jackie

Thanks Jackie and George. She has been given apixaban so her doctors are obviously on the ball.

Gill

None of the fancy stuff for me. If I have a bleed I want them to be able to stop it FAST. I'm sticking to Warfare and my GP seems quite happy with that request.

Murray L

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Tikosyn uptake Dec 2011 500ug b.i.d. NSR since!
Herein lies opinion, not professional advice, which all are well advised to seek.

Hi Murray

I have read that most people on Warfarin are not in the correct range for some (or much) of the time because of the lag between blood test results and dose adjustment, or because of non-compliance. It is very tricky! When I was taking it I was very careful indeed and managed it most of the time.

Gill

The good news on NOACs is that reversal agents are being developed. Some are on fast-track approval, I believe, and should be in emergency medical departments soon. Of course, it could still be some considerable amount of time before they are to be found nationwide and emergency physicians are trained up on them. So I could certainly understand anyone's hesitation with regards to the NOACs based on bleed risks.



Edited 1 time(s). Last edit at 03/09/2017 11:10AM by wolfpack.