getting off xeralto...

I had a 3rd cardioversion in as many months (or less) in January and spent the week in hospital getting on tykosin. I left on xeralto. I know this is a giant discussion on this group and have looked thru the archives.. I had been on xeralto before but just for like a week post hospital. I am having a discussion with my congenital cardiologist and my EP cardio regarding staying on. Is there a real reason to do so? Why not take it if i go into a-fib? I have some skeletal issues and i could really stand to be able to take some ibuprofen. I do have congenital issues as I mentioned- somewhat corrected (aortic stenosis and coarctation of the aorta). But just trying to understand 1) why would i have to stay on this and 2) HOW do you get off? (It seems as if getting off can be a big deal.) I Have been on basically 2 months.



Edited 1 time(s). Last edit at 03/04/2019 04:14PM by bettylou4488.

Do you know your CHADS-Vasc score? It's hard to have a discussion about this without knowing it. You can calculate it here.

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Carey
Do you know your CHADS-Vasc score? It's hard to have a discussion about this without knowing it. You can calculate it here.

so... funny i just talked w/ the doc on this tonight. I am female .. which i told him doesn't count (He said that is up for debate). i have had high BP and i did have a high BNP recently right after the hospital (like 333 I think) at one point I think from metrop- which when i got off (after a bit of lasix) i was fine. no one believes me that was the reason (the metrop) but the same thing happened when i tried it 6 years ago. So my regular (not EP doc) said he'd give me a 2. I think i might just be a 1. Is the taking of the female part out legit?

Yes, subtracting the female point is legit so you're a 1. That's according to the new afib guidelines just issued in January (that's posted here somewhere).

Being a 1 it's a judgement call. You've got some other issues going on that your docs are probably factoring in so I don't know what I would do if I were in your shoes, but with your complex issues I'd be very hesitant to go against their advice, especially if they both agree. Although I know some people who use anticoagulants on an as-needed basis, and I've done it myself in the past with my EP's blessing, you won't find many cardiologists who will endorse the idea. As for how you get off it, you simply stop taking it. There's no tapering required. Not sure why you think stopping it is a big deal.

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Carey
Yes, subtracting the female point is legit so you're a 1. That's according to the new afib guidelines just issued in January (that's posted here somewhere).

Being a 1 it's a judgement call. You've got some other issues going on that your docs are probably factoring in so I don't know what I would do if I were in your shoes, but with your complex issues I'd be very hesitant to go against their advice, especially if they both agree. Although I know some people who use anticoagulants on an as-needed basis, and I've done it myself in the past with my EP's blessing, you won't find many cardiologists who will endorse the idea. As for how you get off it, you simply stop taking it. There's no tapering required. Not sure why you think stopping it is a big deal.

I read on here someone was mentioning the tapering... but the card did say rightly- people go off it cold turkey all the time for surgery. I just don't get... b/c i can go on it if i go into afib but i get I guess-- that there are these statistics. I guess I will go to the EP guy.. pray on it.. and go from there. thanks for your response.

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Carey
Although I know some people who use anticoagulants on an as-needed basis, and I've done it myself in the past with my EP's blessing, you won't find many cardiologists who will endorse the idea. .

Hi Carey,

Thanks for the post. Could you point me in the direction for the for and against arguments on the PIP blood thinner arguments? Thank you!

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MadMax
Could you point me in the direction for the for and against arguments on the PIP blood thinner arguments?

I've never seen arguments for or against it, just individuals deciding on their own they're going to do it. I've never heard of a cardiologist recommending it and the manufacturers don't.

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Carey

Could you point me in the direction for the for and against arguments on the PIP blood thinner arguments?

I've never seen arguments for or against it, just individuals deciding on their own they're going to do it. I've never heard of a cardiologist recommending it and the manufacturers don't.

My EP told me to stop Eliquis. He said if I did have an episode, I should take one.

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katesshadow
My EP told me to stop Eliquis. He said if I did have an episode, I should take one.

Okay, that's interesting. You probably have a forward thinking EP who's willing to "break the rules" in order to provide better care for their patients. I'd keep him or her.

i also know a friend local who does PIP eliquis. I am trying to also understand that CHAD score .. does PIP factor in and how. Like if i am NOT in A-fib does my risk go up or is it simply because i was in Afib at one time. EP doc tomorrow

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bettylou4488
I am trying to also understand that CHAD score .. does PIP factor in and how. Like if i am NOT in A-fib does my risk go up or is it simply because i was in Afib at one time. EP doc tomorrow

PIP doesn't figure into your CHADS score. In short, yes, your risk goes up when you're in afib and comes down when it stops, but to my knowledge nobody has hard numbers on just how much it goes down. People with afib have higher stroke rates even when they've been afib-free for months. To my knowledge, nobody has hard numbers on where you draw the line. That's why having a good EP is important. It comes down to clinical judgement with complex cases like you.

How old are you? I am female, 48, athlete. I take xarelto on an as-need basis... which, now that i have a host of strategies to reduce my afib load, is becoming rarer. I do tend to take the bloodthinner once weekly...that's with no evidence other than my thoughts of 'keeping my body used to taking it'. And, if i suspect i will be in at risk for an AF episode, I will pre-emptively take the xarelto. Of course, if i go into AF, I take one immediately, if I haven't taken one recently. I have 'off-the-record' blessing from my electrocardio for this way of taking my drugs (I also take half a sotalol in the same manner); He acknowledges that I listen to and know my body / heart best, and that there is no RCT for my demographic , so he can't professionally condone my tactic, but he knows i've done my research. He also suggested I keep some clexane on hand, which acts faster than xarelto, should i go into AF .
And. my understanding is that you still want to take the bloodthinners after your have reverted to NSR, as that is the risky time, when the heart is liable to pump a clot into the system.

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katesshadow


Could you point me in the direction for the for and against arguments on the PIP blood thinner arguments?

I've never seen arguments for or against it, just individuals deciding on their own they're going to do it. I've never heard of a cardiologist recommending it and the manufacturers don't.

My EP told me to stop Eliquis. He said if I did have an episode, I should take one.

Good article b Dr John Day. He said he would consider it for himself. See his point #7

[drjohnday.com]