Crossover Plan for Discontinuing Xarelto

Coming up on 6 months post-ablation with 7-day monitoring to begin shortly, I'm hoping with satisfactory monitor results to be cleared to discontinue Xarelto and switch to cardiokinase plus high dose fish oil.

A homeopathic physician whom I recently consulted recommended a crossover as a safe way to discontinue the Xarelto since discontinuation can cause hypercoagulation leading to stroke. He recommended starting the natto and fish oil 48 hours before stopping the xarelto. (Actually, he recommended Plasmanex in particular to reduce clot formation but thanks to Jackie for pointing out that Plasmanex contains maltodextrin which can be mildly excitotoxic; Plasmanex and natto evidently do basically the same thing.)

Is the homeopathic physician's crossover recommendation a good one? Any downside or risk to anyone's knowledge? May or may not be relevant to this issue, but I've run a mildly low platelet count for years.

Thanks, Randy

I should be going off Xarelto in a month. I went off Xarelto for 5 days a month ago due to a baseball bat to the eye. I was not told to do anything besides stop the blood thinner.

I stopped Pradaxa cold turkey without any issues in 2013. The reason I write this is because I do not understand why the need of a "cross over". I know Dr. Natale will not recommend a "crossover"; neither did my Cardiologist.

Is there a possibility of "over kill" here? I ask this because I myself do want to give myself the best shot of staying NSR.

Good question, Smackman. I want to stack the deck in my favor...apparently there is some risk (don't know how small) of clot formation when Xarelto is stopped, hence the crossover idea...but maybe the risk is negligible, I don't know, that's why I'm looking for input.

The Xarelto website mentions risk of clotting from premature discontinuation, but what constitutes "premature"??

"WARNING: (A) PREMATURE DISCONTINUATION OF XARELTO® INCREASES THE RISK OF THROMBOTIC EVENTS,

Premature discontinuation of any oral anticoagulant, including XARELTO®, increases the risk of thrombotic events. If anticoagulation with XARELTO® is discontinued for a reason other than pathological bleeding or completion of a course of therapy, consider coverage with another anticoagulant."

I'm guessing premature simply means stopping Xarelto before the condition it is addressing is resolved...meaning the risk of clot or stroke would come from the underlying condition, not from Xarelto itself. But I still read something...can't remember where...about Xarelto and hypercoagulation which could be due to the Xarelto itself. Will keep looking...

Dr. Andrea Natale took me off Pradaxa and put me on Xarelto. He believes Xarelto and eliqus are btter choices than Pradaxa.

Dr. Natale was involved in some studies with these blood thinners.
[content.onlinejacc.org]

I will read this thread with great interest.

Finding a couple studies that address the issue...findings ranging from stopping Xarelto probably doesn't itself cause clotting or strokes, to unclear and needs more study. Switching from Xarelto to warfarin may increase risk. Otherwise, incidents after stopping Xarelto may have to do with simple transition to an under-coagulated state...hence the importance of nattokinase and fish oil, I'd guess.

[www.consultantlive.com]

[afibprofessional.cardiosource.org]

Wobenzym is also a blood thinning systemic enzyme and another possiblity. I was thining of using this instead of Natto. Any ideas about this?

My nutritionist did a blood test to see if I was getting too much Xarelto since I am on a 20mg dose and am only 102 lbs. My blood test showed I am smack in the middle of the range. I wonder if this means my blood will clot too easily when I go off it and cause a problem. I certainly don't want a stroke!!

Nancy M

Nancy, I don't know anything about wobenzym. Do you have a health issue that would preclude natto?

Nancy - Wobenzyme is an old reliable systemic (proteolytic) enzyme. It was improved upon by William Wong who developed Zymessence... a more potent and comprehensive enzyme system for removing scar tissue and fibrosis.

The Nattokinase enzyme is fibrinolytic and helps manage blood fibrinogen levels important to help prevent adverse clotting.

Yet another popular and highly effective enzyme product is Lumbrokinase... Bouluke use to prevent clotting in cases of hypercoagulation.

Jackie

I stopped Xarelto cold after about 6 months, and I'm a big advocate of tapering. I had no problems at all.

If you have a steady hand and a sharp Xacto knife, you could cut the tablets in half to taper for a few days before stopping completely.

As Randy noted, I don't believe there's a "rebound" effect from stopping Xarelto, the increase in strokes (it was only one study?) probably was due to the original condition.

______________
Lone paroxysmal vagal atrial fibrillation. Age 62, female, no risk factors. Autonomic instability since severe Paxil withdrawal in 2004, including extreme sensitivity to neuro-active drugs, supplements, foods. Monthly tachycardia started 1/11, happened only at night, during sleep, or when waking, bouts of 5-15 hours. Changed to afib about a year ago, same pattern. Frequency increased over last 6 months, apparently with sensitivity to more triggers. Ablation 6/27/13 by Steven Hao.

So, Jackie, are you saying that Wobenzym would be okay to use instead of Nattokinase when I go off Xeralto? I was on it for four months about 6 years ago and really liked it. My nutritionist says I need to clear all the debris and undigested protein out of my system and suggested Wobenzym, but we decided I need to hold off on using it until I'm off Xeralto.

Thanks,
Nancy M