Mixing Xarelto & Eliquis

I have a quick question please: I recently started some old Eliquis samples (recently expired) & I also have about 14 Xarelto pills (also expired). Before I start my newly filled Eliquis, may I finish off the Xarelto pills 20 mg once a day, then go back to Eliquis 5 mg b.i.d.?

Thank you.

Assuming they're not years past expiration that shouldn't be a problem.

Here is an article on drug expiration dates. [www.health.harvard.edu].

Thanks, but I wasn't too worried about expiration. So it is no problem also to finish out the Xarelto in the middle of my Eliquis? What I mean is I started older Eliquis samples when I got flutter & I have a script for new Eliquis I am filling. But I also have 2 wk worth of Xarelto I took a few years ago to finish as well. I thought I might finish the Eliquis sample thru June, then finish the Xarelto 14 days, then start back on Eliquis with my fresh script.

And, the Eliquis samples exp date is Sept 2022; the Xarelto script said use before August 2021. I took Xarelto in 2020.

Like I said, shouldn't be a problem.

I would leave at least the normal dosing time between the two. So 12 hours for Eliquis and 24 hours for Xarelto. For example, if you take your last Eliquis on a Monday morning, I wouldn't start the Xarelto until Monday evening. And if you take your last Xarelto on a Monday morning, I wouldn't start the Eliquis until Tuesday morning.

There really aren't any formal guidelines on this, so I'm just applying common sense, but both drugs have a wide safety margin on dosing so you're unlikely to do yourself any harm no matter how you do it.

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Carey
I would leave at least the normal dosing time between the two. So 12 hours for Eliquis and 24 hours for Xarelto. For example, if you take your last Eliquis on a Monday morning, I wouldn't start the Xarelto until Monday evening. And if you take your last Xarelto on a Monday morning, I wouldn't start the Eliquis until Tuesday morning.

Thank you.

Was just remembering I need to know certain things pre-ablations: isn't it one month minimum of being on a blood thinner before ablation?

Also here is a bit more info on that Xarelto: the script was for 8/5/20 & on the bottle it said use before 8/5/21 (the latter of which I was counting as the expiration date). I only have 11 pills. Should I toss or take? I don't want to mess anything up if I get in for ablation soon.

Luckily the Eliquis samples, like I said earlier do not expire til Sept 2022.

Sorry to be so redundant & getting mixed up. My apologies in advance.

Pharmacies commonly say use before one year of issue. I’ve gotten meds with a much longer expiration date from the manufacturer, but pharmacy still puts the one year expiration date on their label. A pharmacist could give you a better answer, or the EP team doing the ablation.



Edited 2 time(s). Last edit at 06/08/2022 04:55PM by GeorgeN.

Thanks GeorgeN

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GeorgeN
Pharmacies commonly say use before one year of issue. I’ve gotten meds with a much longer expiration date from the manufacturer, but pharmacy still puts the one year expiration date on their label. A pharmacist could give you a better answer, or the EP team doing the ablation.

Thus I always insist on getting the manufacturer’s bottle and not the pharmacy’s vial bottle to get the exact date and not a guess.

The manufacturer’s bottle has the expiration date and lot number. Lot numbers are invaluable if there is a drug recall because it takes the guesswork out of wondering.

I once had a faulty lot of Tenormin. My blood pressure (somehow this BB reduced my BP) became unusually high @124/114 so I had to go to the ER after a day of headaches. It used to be 115/65. I called the manufacturer and was asked the lot number. Having the bottle I knew. It seemed there was a 4 day blizzard in the east coast and the truck was stuck and the drug’s potency decreased rendering it useless. They knew from the lot number.

I wonder how on earth you get the pharmacy to give you the mfg's bottle, i.e., unless you are getting the whole amount in the bottle instead of a 1-mo supply or such. I can't imagine the flack I would get if I asked for that. I have enough trouble getting the mfg I want for certain scripts & also having the scripts transferred to another store if the dr called it in & I wanted to check prices after I saw the cost & use GoodRx at another store. You know how busy the pharmacies are & how hard it is to get a pharmacist on the phone. It is quite a management game getting prescriptions the way you want (mfg, amount, price w or w/o ins). Aren't you married to a pharmacist though - does that make it easier? I know what you mean about lot #s as I went through a recall with a batch of thyroid med once & they were trying to determine lot # by date script was filled.

These are rhetorical questions, Susan, so don't put any energy in answering them. I know you are very good at managing things & I could not do all that you do.

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Madeline
I wonder how on earth you get the pharmacy to give you the mfg's bottle, i.e., unless you are getting the whole amount in the bottle instead of a 1-mo supply or such. I can't imagine the flack I would get if I asked for that. I have enough trouble getting the mfg I want for certain scripts & also having the scripts transferred to another store if the dr called it in & I wanted to check prices after I saw the cost & use GoodRx at another store. You know how busy the pharmacies are & how hard it is to get a pharmacist on the phone. It is quite a management game getting prescriptions the way you want (mfg, amount, price w or w/o ins). Aren't you married to a pharmacist though - does that make it easier? I know what you mean about lot #s as I went through a recall with a batch of thyroid med once & they were trying to determine lot # by date script was filled.

These are rhetorical questions, Susan, so don't put any energy in answering them. I know you are very good at managing things & I could not do all that you do.

My pharmacist husband is retired but he trained me well to get the bottles. Eliquis brand comes in a 60 tablet bottle-30 day supply. They toss the manufacturer’s bottle otherwise. Which reminds me of a story- I once went to pick up my 60 tablet bottle of Eliquis and saw they didn’t follow the instructions on my record of giving me the manufacturer’s bottle and instead a generic vial. The pharmacist had just filled it so she reached inside the trash and handed me the bottle so I would have the lot number. There was one rogue tablet left in the bottle and I was given 59 tablets originally not 60. If you request the actual bottle, it comes sealed with the cotton ball and the correct number of tablets. If I recall- Tenormin brand contains 90 tablets so I would get 90 day supply and two bottles. You shouldn’t have to be concerned about brand drugs. Crestor brand pills are small quantity.

If I was concerned about massive bottles of generic drugs, I would ask to see the bottles and I snapped away with my phone the expiration date and lot.

Only commonly used drugs the chains typically uses in a pill dispenser/counter, and they comes in massive bottles as you described. I’m not worried about those drugs or lot numbers. Even when I was on flecainide I got the genetic manufacturer’s bottle. It doesn’t have to be brand.

Just ask the pharmacist. Please don’t bother them on a Monday morning after a weekend when they are playing catch-up filling RXs that were backlogged and left on the counter from the weekend’s pharmacist substitutes. I never had any complaints and my drugs are filled at a competitor pharmacy so having a pharmacist in the family has no clout. Just ask nicely.



Edited 1 time(s). Last edit at 06/08/2022 11:43PM by susan.d.

This varies from place to place. My Eliquis comes from Walgreens in the manufacturer's sealed bottles. Although the pharmacy puts their prescription label over the manufacturer's label and it always shows a 1-year expiration date, I can still see the manufacturer's expiration date, which is what I follow plus a year or two. But I'm pretty careful about keeping drugs in cool, dry, dark places. If you're someone who keeps drugs in your car or a bathroom with a shower, then I would believe the pharmacy's expiration date. I think that's what pharmacies assume people do (plus they want to sell you more drugs).

Studies show more women get pregnant in the hot summer months in the east coast due to their birth control pills not being stored between 68-76 degrees.

I have my AC running when I’m not home. I keep an insulation bag with my meds in the bathtub inside two insulation coolers (no ice to cause humidity) with silver insulation bags you get at the market for frozen foods stacked over and then a winter down jacket encapsulating over that. I have a thermometer inside the bag and a display on the exterior showing the temperature so I can remotely adjust the AC. With my ring camera I can remotely see that my sotalol and Eliquis and BP drugs are properly at the right temperature insuring ultimate potency.

I’m a little type A. :-) but my drugs work.

That's more than a "little" type A. ;-)

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Carey
This varies from place to place. My Eliquis comes from Walgreens in the manufacturer's sealed bottles. Although the pharmacy puts their prescription label over the manufacturer's label and it always shows a 1-year expiration date, I can still see the manufacturer's expiration date, which is what I follow plus a year or two. But I'm pretty careful about keeping drugs in cool, dry, dark places. If you're someone who keeps drugs in your car or a bathroom with a shower, then I would believe the pharmacy's expiration date. I think that's what pharmacies assume people do (plus they want to sell you more drugs).

Carey,

I get my blood thinner (Xarelto previously & Eliquis currently) from Walgreens too. I haven't filled the Eliquis yet. I do see the Xarelto bottle is original, but the pharmacy's label covers the original label & when I tried carefully to peel it off some of the label was missing & I stopped. I did not see anything that said exp date or lot date, except exp. as on the folded over label Walgreens put over the bottle.

I keep my important drugs in cool dry rooms that are not in direct sunlight.

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Madelline
I get my blood thinner (Xarelto previously & Eliquis currently) from Walgreens too. I haven't filled the Eliquis yet. I do see the Xarelto bottle is original, but the pharmacy's label covers the original label & when I tried carefully to peel it off some of the label was missing & I stopped. I did not see anything that said exp date or lot date, except exp. as on the folded over label Walgreens put over the bottle.

I also get Eliquis from Walgreens in the manufacturer's bottle and though they slap their label on the bottle it doesn't cover up the expiration and lot # from the manufacturer.

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Carey
That's more than a "little" type A. ;-)

I’m drug sensitive and 160mg a day of Sotalol doesn’t work, but knock on wood, for over 5 months 200mg a day has work so far. I’m not tempting faith.. That’s on fully potential temperature control drug storage conditions with my double insulation bags and temperature checks. It’s a fine line of having a life or being weekly admitted every Saturday to Tuesday from thanksgiving to 1-8. I don’t know the exact dose between 160 to 200 that works so I do whatever it takes to stay in nsr with my anal-ness.

So I say proudly I am a full pledge type A if it keeps me out of the ER.

I don’t care about Crestor or Prilosec or other drugs. I just get the chain pharmacy to fill it in a regular vial and never bother. If it expired (my Prilosec is expired for over a year) I don’t care because I won’t end up in the ER. Sotalol and half dose Eliquis without an aspirin and without a 6 month TEE is a different story.