Xarelto and Liver Enzymes

I got my ablation report back from Dr. Natales office and when looking at the routine blood work that was done I noticed that two of the categories were elevated, both are tied to the liver. My SGOT-AST was 45 (normal 5-35) and my ALKALINE PHOS. was 178 (normal 34-122). I had very extensive bloodwork done a couple of months ago from a hematologist and all liver categories were normal. I talked to both Dr. Natales office as well as my regular cardiologists office and they both say that Xarelto is processed through the kidneys and not the liver, however when I do a search on Xarelto and liver enzymes it says that it can raise certain liver enzymes. I say all this to ask has anyone else who is taking Xarelto notice that any of their liver enzymes have increased.

Thanks,

Ken

I thought I would list this for anyone else who is taking Xarelto and may run into the same situation.

I found this on the Website for Xarelto, I removed all the other side effects which were to many to list. It does show that it can increase the blood alkaline phosphatase levels.


Undesirable effects:

Common: increases in: bilirubin, blood alkaline phosphatase, LDH, lipase, amylase, GGT.

Hi Ken,

Good report, most docs are still learning about the NOAC drugs, as is everyone else and are still just making somewhat educated guess's about what their side effects might be. We wont have a clue about the full extent of possible side effects from these drugs for another few years yet.

Like all new 'wonder drugs', they all look great coming out of the chute. It always takes some years in the wild before you can make an honest judgment about the various risks versus benefits really is of a given systemic drug taken by millions on a large scale. Stay tuned for more such caveats as time goes on.

Shannon

I have a week left of my Pradaxa 150Mg tablets and then am to switch to Xarelto 20Mg (already have initial bottle of 90) . However, I am now pondering not changing. Since both are dangerous drugs (side effects, non reversal of bleeding etc. and Ken H's report) ------------- Pradaxa appears more effective in preventing clots:

Analysis Gives Edge to Pradaxa Over Xarelto
[www.medpagetoday.com]
[www.levinlaw.com]

Thank you, Ken, forXarelto/ liver info.

Stephen

Just wanted to give you an update on the liver enzymes, I got a message back from my hematolgist's office and he wasn't concerned about the numbers being elevated, he said that they were only marginally elevated so he instructed me to stay on the Xarelto. I will stay on it but I can't wait to totally get off it in a few months.

Hi StephenL and Ken,

I wiuld much prefer Xeralto to Pradaxa. At least with Xeralto there is an outside chance if you had a major bleed or accident and you lived near a major Level 1 trauma center that they might be able to save you using PCC (assuming the ER is a large enough one to stock PCC and they would be willing to spend on you the $10,000 per dose cost to administer PCC.... Also with Xeralto and Eliquis the two current factor XA Inhibitors there is a porential reversal agent in the wirks but that is not the case with Pradaxa.

Otherwise with Pradaxa you have no choice and your main hope in Serioys bleeding accident us that the accident happened long enough after your last dose of Pradaxa that you will hit the half-life if the drugs effectiveness before you bleed out. That's a risky gamble and in the only study so far, soon to be published,

72% of those admitted on Pradaxa for a serious traumatic bleed to the largest volume Trauma center in the US died in the ER or shortly after admittance to the hospital itself.

That is compared to 27% on Warfarin and 29% on Plavix who also died for the similar comparable level of Trauma. In other words, Pradaxa is 43% more likely to kill you than Plavix and 45% more likely to kill you than Warfarin for the same degree of serious internal bleeding or serious bleeding trauma! That is a HUGE difference in safety!

Plus Pradaxa seems even more likely to cause serious GI bleeds than the other NOACs in any event. In my view, Pradaxa has little reason for existing with both Xeralto and Eliquis being on the market. Even though I also have serious reservations about both Xeralto and Eliquis until an effective reversal agent is in the field.
But once that agent is in place world wide, I think it would then be absolute mal-practice to prescribe Pradaxa to anyone!

Shannon

Please please please... remember that you only have two kidneys that perform in unison. And you only have ONE liver. They are to be treated with kid gloves at all times. On TIKOSYN I have bloodwork monthly seeking any anomalies in levels associated with my kidneys or liver and am advised by THOSE specialist (I bet I have more specialists than YOU! I win.) to come RUNNING if anything is amiss.

We have lost too many friends and family to kidney and liver issues to think nonchalantly about these things, the latest only 3 weeks ago. My wife lost her father to kidney failure that was not treatable by dialysis.

Just a word in the ear to those that care to hear it.

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.

Thank you, Shannon.

I've ordered another bottle of Pradaxa [www.aboutlawsuits.com]

And, then may have to flip a coin as to which to take:

Efficacy. Pradaxa may have a slight advantage. Pradaxa 150 mg BID prevents about 5 more strokes per 1000 patients/year than warfarin.
Xarelto 20 mg once a day works about as well as warfarin...but this is in higher-risk patients than those in the Pradaxa trial.
[prescribersletter.therapeuticresearch.com]

Stephen