5 vs 2.5 mg eliquis

Have read many threads where posts reference 5 vs 2.5 mgs of eliquis. In what circumstances is one dose or the other prescribed or preferred? Is one's blood less thin with a lower dose than another? Does a higher dose result in more stroke prevention. If you take a lower dose could you take an nsaid with less worry about a brain bleed etc.

I found one article, which I'll try to link (first time), which attributes factors such as age, weight, and renal function as determiners. Is that always true or just the case within the bounds of this specific study?

Thanks

[www.ncbi.nlm.nih.gov]

That article is informative but a bit old. There's no point in comparing Eliquis to warfarin at this point. It's already been proved superior to warfarin and has a lower bleed risk. The basic conclusions of that study stand for most people, but there's really no need to be looking at research studies. EPs have already done that for you and arrived at a consensus.

As used in clinical practice, 5 mg is for active preventative use in most adults, and 2.5 mg is for maintenance use and also for patients with lowered tolerance (low body weight, age > 80, impaired kidney function). So if you have active afib, are otherwise healthy, under 80 years old, and aren't particularly low weight, you should probably be taking the full 5 mg dose. If you don't meet one of those criteria, you might be better off on the 2.5 mg half dose.

There are also cases like me. I no longer have active afib, and I even have a Watchman device, but I showed mild aortic plaque on a TEE in 2017 (along with almost everyone else in the western world over 60 years). That gives me an additional CHADS point and would cause almost any doctor to put me on daily low-dose aspirin. But Dr. Natale, my local EP, and my PCP all agreed that half dose Eliquis was a safer, more effective option than aspirin. So that's what I've been taking for two years and I anticipate continuing indefinitely.

So if you don't have active afib but have other risk factors that might lead a doc to prescribe a daily aspirin, the 2.5 mg half dose might be appropriate (instead of the aspirin). In the end, it's always an individual decision based on individual factors, so there's no way to say "Sure, it's safe for you to take long-term NSAIDs if you're on the half dose." All you can say is the risk of bleeds caused by combining Eliquis with NSAIDs is lowered if you're on the half dose.



Edited 1 time(s). Last edit at 12/20/2020 11:46AM by Carey.

Thanks, Carey. Very informative and much better understood than the study. Stay safe.

Carey,

You mentioned that Natale has you on 2.5 Eliquis instead of aspirin due to plaque issues, despite you having the Watchman. In making that decision, was there any concern that Eliquis might not be as effective as aspirin in preventing clots of the wall on the Watchman even after tissue forms over it? Like you I have the Watchman and am thinking of stopping aspirin because of gut issues and switching to 2.5 Eliquis. I took 5mg Eliquis before the Watchman implant and for 3 months after, then went solely aspirin.