Rash/itchy

I didn't get much sleep last night because I was itching---I have always had a few small moles on my chest and back but the last few days my back, stomach area, shoulders and neck are really itchy, I have showered which makes it feel better for a little while. Then I just want to itch and I have scratched some areas rather bad.. I have had some itchy moles but not anything quite like this, I have read that a rash can be a side effect from Eliquis, I will go to see a Dermatologist as soon as I can.

I am wondering if anybody has had any reaction such as I have described and if so what did you do?

Also can one take Benadryl if they are taking Eliquis?

Liz



Edited 1 time(s). Last edit at 12/26/2019 03:16PM by Elizabeth.

I looked up 5 prescriptions I take and Rash and swelling were always mentioned. I think it’s just a generic statement on most prescriptions.
I have taken Eliquis for years with no issue except easy bruising etc.Here is Valsartan;
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

I despise a blood thinner but I also like living.🤣

Smackman":

The dermatologist wasn't in today, I will call tomorrow, get this checked out. I know I read that Eliquis can give some a rash, it could be caused by something else, it just is at the same time that I am taking this drug.

Are you in still in AF?

Liz

No rash/itch with Eliquis. However I look like a leper while on Multaq. Drugs.com mention itch and rash. My rash is nose, checks and forehead. The itch extends from head to between toes and inside eyelids and ears. I’m used to it but the rash is horrible. I have to use topical steroids for it.

Susan:

Oh my gosh that is awful, a rash on your face, ears and inside your eyelids, how long did it last, I hope you no longer are taking Multag. I was thinking about taking Benadryl, I just wasn't sure if it is ok to take while taking Eliquis.

Liz

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Elizabeth
Smackman":

The dermatologist wasn't in today, I will call tomorrow, get this checked out. I know I read that Eliquis can give some a rash, it could be caused by something else, it just is at the same time that I am taking this drug.

Are you in still in AF?

Liz

No I had 2 Ablations with Dr. Natale with the last one in July 2016.

Liz:

Did you get Cardioverted? or are you still in AFIB?

Anti fib

They have set the date for me to be Cardioverted on the 16th of Jan., I still am in AF but it is so mild that I constantly take my pulse to see if I really am in AF. The only time when I know I am in AF is when I go walking and doing some heavy work, otherwise when just moving around in my house my heartrate is quite normal, it is strange.

They have sent me a script to get some bloodwork a couple of days before the Cardioversion, A basic metabolic profile and blood survey and platelet. I hope it works.

Liz

Hi Liz - yes, I have some itchy skin bumps. These are not moles, but are new eruptions that began when I started taking Eliquis.... even with the half-dose I have them. Some become large and painful. I've found that a variety of essential oils...dabbed right on the bump takes away pain and itching but it can take a very long time for the lesion to disappear and even then, it leaves a dark red mark. Eliquis is the only med I take.

Jackie

Jackie:

I really have a bad rash now, it is on my back, shoulders, my sides and some on my stomach, I have a few moles but I have had some, the rash is around the moles and it itches. I called the doctor that prescribed the Eliquis and he wasn't in, they said his nurse would call me and she never did. I will call tomorrow and also try to get in to a Dermatologic. I am in trouble if this cannot clear up unless the drug is stopped, then what, I am in AF all the time now. I was thinking of getting the Watchman but wanted to wait until the new one comes out in March.

Hopefully I can go into NSR when I get cardioverted, but that wont be until the 16th of Jan., unless they up the date. Even if I do go into NSR can the Eliquis be stopped?

Liz

Probably not a good idea to stop ant-coagulation drugs at this point? Why not switch to another one and see?

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Elizabeth
Hopefully I can go into NSR when I get cardioverted, but that wont be until the 16th of Jan., unless they up the date. Even if I do go into NSR can the Eliquis be stopped?

Not until a month after the cardioversion, and then it will depend on your CHADS-Vasc score.

In the meantime, like Joe said, just switch to one of the other NOACs.

Carey, you should know from experience with knowing Natale procedures- how long (ball park) would someone who had an ablation need to remain on Eliquis? I saw him recently but we didn’t discuss it —discussed my high % of PVCs instead.

Just curious...also what I posted in the past, my Zio patch showed no AF...but I am on Multaq. Dr Natale was gracious enough to allow me to be on Multaq two months longer (4 months post ablation on January 18th to stop) because my regular EP original commented all of his patients go 6 months. Natalie was comfortable with me stopping Multaq after 2 additional months blanking period.

Now here is an interesting flip. I saw my regular EP on Friday (to keep him active and he wanted to update my stats post ablation). After he listened to my freak show PVCs (full force) and took an ekg —my PVCs are limited to my right ventricle—he told me he thinks Multaq could possibly be the PVCs trigger and to stop multaq. However, I’m leaving for the Middle East in a week, and want the protection for my 12 day trip as insurance my AF won’t start up—It’s a long flight and many hills, language difficulties. In March I was there visiting my son and my AF was nonstop without medical care- my son lives in a remote village in the mountains without a hospital. So I wasn’t cardio converted and my travel insurance paid for an emergency business :-) flight home. I don’t want to deal with that again so I plan on staying on Multaq until the 20th...just in case.

It would be wonderful if multaq is a reason for all my 27.8% PVCs (I think it’s higher now). I can’t wait to stop it. All the drugs are toxic IMHO. I actually did an experiment and stopped my PPI Prilosec today and yesterday because I wanted to be active and not symptomatic and my PVCs were there but very mild -one out of four beats- I couldn’t tell without glimpses on my Iwatch ecg... until after I took my evening Crestor, fish oil and CoQ10 tonight. Then they are very symptomatic. I’m trying to find my pvc trigger. Anyone try to figure out PVCs triggers?

Thanks Carey for posting olive leaf extract. I asked my EP and he said to try but not to try taurine. He was very verbal about taurine. I have to ask natale office when I return their advice which is primarily at the moment. But thanks for the tip.

I’m curious how long a typical natale patient with no post AF remain on Eliquis? My local EP can’t answer the question because he doesn’t know if my LAA was touched. His concern is I “will”- not “might” stroke. It’s up to Natale for final discussion. My EP recommended natale.

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susan.d
Carey, you should know from experience with knowing Natale procedures- how long (ball park) would someone who had an ablation need to remain on Eliquis?

Sure, and the answer is one month to forever depending on the patient. But Elizabeth hasn't had an ablation. She's looking at a cardioversion, and the standard of care is anticoagulants for one month following a cardioversion.

Thanks Carey. I get I just wait and be surprised.

I went to see an NP this morning to check out my rash. This NP looked at it and immediately said that it was Shingles and prescribed a antibiotic cream. I did speak with a doctor in the anti-coagulation dept. at U of M to let her know and apparently I will stay on Eliquis.

A question is in my mind which I didn't think to ask the doctor and she is gone for the day now. Could the Eliquis cause my immune system to weaken so that is why I got Shingles, and if that is the case, that isn't a good thing.

Liz

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Elizabeth
I went to see an NP this morning to check out my rash. This NP looked at it and immediately said that it was Shingles and prescribed a antibiotic cream.

That I don't understand as Shingles is caused by a virus. I have had it and took oral Valtrex (and anti-viral)--cleared it up in a few days. I think about 1 in 3 get Shingles as we age.

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Elizabeth
A question is in my mind which I didn't think to ask the doctor and she is gone for the day now. Could the Eliquis cause my immune system to weaken so that is why I got Shingles, and if that is the case, that isn't a good thing.

No, Eliquis has no effect on the immune system. Sorry about the shingles, but it happens to a lot of people with perfectly fine immune systems.

I went to the ER tonight because earlier I had blood in my bathroom stool, it was a bright red, it came from my Anus. They checked me and I explained also that the last couple of weeks I had a hemmeroid I haven't had any problems like that in years and years, I checked out ok but I was told to get a colonoscopy, which I will do. I don't believe I have shingles, what I have does not hurt at all but itches, I showed the doctor in the Emergency unit and she agreed with me, she does not think my rash is shingles.

My belief is that the Eliquis is causing all my problems, it can cause a rash, and a bleed. No one is in the Anti-Coagulation dept. at U of M, I will call on Thursday. Perhaps dropping the 5 mg. to 2.5 mg. might help me.

Happy New Year
Liz

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Elizabeth
Perhaps dropping the 5 mg. to 2.5 mg. might help me.

That's not how you find out if a drug is causing your problem. You change to a different drug. You've got four other drugs so plenty of options.

Elizabeth

Google "shingles" and go to images. It's pretty clear what shingles looks like. I had it on the upper left quadrant of my face about 35 years ago. Nasty and ugly, but no pain. I don't recall much of an itch.

I don't agree that reducing dosage is not useful as a tool for assessing and ameliorating side effects, especially if there are some benefits to be had with remaining on a particular drug. Modern medicine is increasingly moving towards a personalized approach, including pharmaceutical dosing. The problem is that drug studies are not sufficiently stratified to make a priori recommendations, hence the need for experimentation. Of course, it should be done under the guidance of an MD who is knowledgable.

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safib
I don't agree that reducing dosage is not useful as a tool for assessing and ameliorating side effects, especially if there are some benefits to be had with remaining on a particular drug.

I didn't say it has no role, but reducing a dose to what might be an inadequate level would be foolish when there are four perfectly good alternatives available. Also, allergies often don't go away simply because the quantity of allergen is reduced. So if she reduces the Eliquis to a half dose and the rash doesn't go away, that tells you nothing. You still don't know if it's the Eliquis causing it or not.

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Carey
I didn't say it has no role, but reducing a dose to what might be an inadequate level would be foolish when there are four perfectly good alternatives available. Also, allergies often don't go away simply because the quantity of allergen is reduced. So if she reduces the Eliquis to a half dose and the rash doesn't go away, that tells you nothing. You still don't know if it's the Eliquis causing it or not.

It is not foolish at all. There are good reasons for preferring Eliquis. Also, allergies (and sensitivities for that matter) are very much dependent on dosage. Establishing thresholds for allergies is an important area of research. And if she reduces the Eliquis to a half dose and the rash does go away, that rejects the null hypothesis and tells you a lot. It is a perfectly reasonable thing to discuss with her MD or EP.

If Jackie is reading this perhaps she will tell us if reducing her Eliquis from 5.0 mg. to 2.5 was of help to her. Jackie was put on 5.0 mg. of Eliquis and was finally dropped to 2.5mg. I recall that she was having nose bleeds.


Liz

I take Snythroid for my thyroid, if I took 135 mcg. every day I would become hyper and all kinds of problems would arise. I take 125mcg. and I am ok. I think the dosage of a drug is important, but I do understand what Carey is saying that it is the drug itself not the amount taken that is causing problems. Those other anti-coagulants and Eliquis are all similar, are they not, but it is worthwhile to try a lower dose.

Liz

Hi Liz - First let me comment that I am very sorry you are having all these difficulties.
I can understand your frustration and concern.

Six months after my 2015 touch-up ablation (post LAA isolation in 2014), I was able to reduce the 5 mg BID dose of Eliquis to 2.5 mg BID. I remain on that as advised by Dr. Natale mainly because of my age. All of my stats were OK.

The nose bleeds happened early on with the full dose Eliquis and were a result of dry air and dry nasal tissue.
I consulted with an ENT who advised lubricating the nasal tissue often during the winter when the air is more dry (even thought there is a humidifier on the furnace).. and that has seemed to work well. I'm still cautious with the half-dose as I have had a variety of minor cuts and small scrapes that still bleed copiously. Just annoying.

(Incidentally, FYI... You and I have always shared the low-platelet count dilemma... but my recent labs this fall indicated they had elevated to normal range. Apparently, the recommended focus on a group of B-related nutrients eventually worked. )

Take care,
Jackie

Thank you for your response Jackie. Did you have nose bleeds before you took Eliquis? The last blood draw my Platelet count is still low, just below the bottom limit. I have taken the B vitamins since my 20s, my B12 is usually over the lab limit, so I am good on the Bs.

I was reading that in Australia they put those that are over a certain age on 2.5 mg. of Eliquis not the 5 mg.

Liz

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safib
It is not foolish at all. There are good reasons for preferring Eliquis.

If there wasn't an alternative I would agree with you, but there is. The advantages of Eliquis over Xarelto are so minimal as to be meaningless. I can't imagine why anyone who suspects they have an allergy to a drug would lower the dose when a completely different and equally safe and effective drug is available. Why fiddle around with lowering doses only to find that the rash doesn't go away -- which leaves you not knowing if you're allergic to it or not -- when you could simply switch drugs and know with certainty right away?

As for Liz's question about lowering the Eliquis dose based on age, the guidelines are:

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Patients with at least 2 of the following:

1. age ≥80 years
2. body weight ≤60 kg
3. serum creatinine ≥1.5 mg/dl

So if Liz is 80 or above and weighs under 60 kg (~132 lbs) or has some reduced kidney function, then the half-dose would be appropriate. Otherwise, the full dose is recommended. I doubt if many doctors would be willing to go outside those guidelines and risk a stroke just to avoid a rash.

Carey::

I am over 80, I weigh a few lbs over 132, I weigh 138, my Creatinine is 0.89, the lab value is 0.60 - 88 mg/dl , so I think I should be taking the 2.5 Eliquis . The doctor I spoke with is a Pharmacist in the anti-coagulant division of U of M, he was a little unsure about prescribing the 2.5 mg. he had recommended Xarelto first, said they were the same. I guess it doesn't matter how old or how much you weigh on the 5mg. dose of Eliquis, a 300lb man and a woman 138 lbs take the same dosage, doesn't quite make sense to me.

Liz

The Eliquis guidelines in the state I believe is 65 and Europe 70. That was my original argument when I saw my EP the day after my 65th birthday. Unless Europe guidelines changed in the past 3 years.

Can you lose 6 pounds to help mor your EP?

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Elizabeth
Carey::

I am over 80, I weigh a few lbs over 132, I weigh 138, my Creatinine is 0.89, the lab value is 0.60 - 88 mg/dl , so I think I should be taking the 2.5 Eliquis .

You meet one of the three criteria and you're close on a second (weight), so it's a judgement call on your and your doc's part.

You seem really intent on getting on a half dose of Eliquis even though you think it's causing a rash instead of trying another drug like Xarelto. If I were in your shoes, I'd try Xarelto to see if Eliquis is causing the rash. If it is, problem solved! And if it's not then you can go back to Eliquis and maybe a half dose.

Jackie is not in AFIB, so reducing to 2.5 makes more sense. Elizabeth is in AFIB, Eliquis at 5mg is what is thought is best for Clot prevention while in AFIB.

Dr. SIanjay Gupta says that AFdoes not cause strokes, it is the cormorbilities that cause strokes If you have high blood pressure, diabetes, heart failure, age. There have been studies done, one in 1987 in the New England Journal of Medicine where they took people age 60 and under who had AF , which they followed for 15 years only 1.3% had a stroke. Another survey was run in 2007 on older people that had cormorbilities and were over 73 they had a high risk of stroke and 3/4 of that group died.

It is an interesting segment on You Tube by Dr. Sanjay Gupta.



Edited 1 time(s). Last edit at 01/02/2020 03:51PM by Elizabeth.

Carey:

Well, I just spoke with the doc. at the anti-coagulation clinic and she is switching me to Xarelto to see if my rash will clear up. Now Carey did you talk to her (just kidding, need a little levity).

Liz

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Elizabeth
Now Carey did you talk to her (just kidding, need a little levity).

Yes, I'm secretly a Xarelto sales rep so I gave her an all-expense paid trip to Hawaii.

There is no reversal agent for Xarelto, is that right?

Liz

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Elizabeth
There is no reversal agent for Xarelto, is that right?

Nope! Andexxa is the reversal agent for Xarelto and it's available in the US. It also works for Eliquis.

I predict that you'll never need it and no one else here or anyone you've ever heard of will need it, but it's available in the extraordinarily unlikely event you do.

Look up keto rash. scroll down on the search to see some images of it.
[www.google.com]

Todd:

I am not on a Keto diet, i eat meat, eggs, beans, all fruits and veggies, starches like bread, some potatoes. Thank you, i did look at the pics, there are so many kinds of rashes and some look like mine, but my rash began after I started Eliquis. I just quit the Eliquis and started on Xaralto, I still have the rash/itchy so will see if it will subside.

Liz

I suggest that you check the price of Andexxa. I show the wholesale acquisition cost of the standard dose regimen is $24,750, and the high-dose regimen is $49,500.

NCBI Andexxa



Edited 1 time(s). Last edit at 01/04/2020 09:17PM by Jim Benton.

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Jim Benton
I suggest that you check the price of Andexxa. I show the wholesale acquisition cost of the standard dose regimen is $24,750, and the high-dose regimen is $49,500.

Yep, but that's okay because you're never going to receive the drug because you're never going to need it. The company that makes it knew you'd never need it, so they priced it according to the expected sales.

The reversal agents for NOACs were developed mainly as a marketing tool. They exist because patients feel safer knowing they exist, so they're more willing to take the NOAC. They also exist as treatments for accidental/intentional overdoses.

A reversal agent has been around for several years for Pradaxa and it's virtually never used. Thousands of trauma patients flow through major medical centers and almost none of them gets these drugs.

Why? Because NOACs aren't warfarin. They wear off in hours, not days, so they don't need reversal agents. If you have a serious bleed while on Eliquis, Xarelto, Pradaxa, etc., all they have to do is stop giving you the drug. You'll be back to normal clotting status sooner than if you had been on warfarin and they gave you vitamin K.

The only real use for the reversal agents is when your 2-year old grandchild gets into your Eliquis and swallows half a bottle.