Cutting 5mgs Eliquis in half

I have been following the topic “Over 2 months since my ablation” and there was some discussion about splitting Multaq . I know many folks who received a Watchman were told to start taking a half dose of Eliquis twice daily. I have been doing that. I was given a pill cutter when discharged but I know that when I cut the 5mgs Eliquis the halves are not always the same size. I just keep doing it, hoping that it will not cause an issue.

I am now going to quote Daisy from the topic mentioned above, “. I wonder how they make the tablets that would make the drug inconsistent through the tablet?”.

That was a perfect way of saying what I have been thinking. How worried should I be about cutting the Eliquis? I know it comes in a 2.5mgs dose, but I just had a three months supply of the 5mgs filled.

It's not inconsistency throughout the tablet, but the bioavailability over the interval between doses, but also residual effects. For example, after being on 100-200mg of Amiodarone for several weeks, you will have the iodine in your system for a number of weeks afterwards. So, Amiodarone has a high 'half-life' bioavailability. It's the same, although in the world of nuclear physics, with radioactive decay. Some medical shadow agents used in imaging have half-lives measured in a couple of hours, while cesium 137 has a half-life around 30 years. It means at the 30-year mark, approximately half of the radioactive decay will still be taking place.

I believe apixaban has a half-life near 12 hours, maybe more...I haven't checked and keep forgetting. So, a missed dose is not going to cause undue harm as some of it is always available to those who ingest it regularly otherwise. Even so, the process of creating tablets of drugs is high engineering stuff, and the 'mix' is quite homogenous. This has to be for one reason, and it's not so that a tablet can be cut in half (but that is a benefit of what follows): the reason is that the dose must be consistent from tablet-to-tablet. You can't expect that and not have homogeneity across a sample of randomly selected tablets, which is how you get them from the pharmacy and how you ingest them when you select one from the vial.

I use the following link product to cut my Eliquis. You line up the middle of the “5”’while keeping the pill straight. Perfect cuts each time.
[www.amazon.com]

I now have to increase my cardizem to a dose they don’t have a pill for. So I get my 60 and quarter them. Technically it would be easier to take 60mg 4/day but the dr wants it in three doses so I quarter them instead of triple them to change 60 to 80. The dr said then take a 1/4th which is 75mg each dose. Close enough.

If your watchman is sealed and doesn’t leak after 6 months you shouldn’t worry if one pill is 40% and the other 60%. You are protected by your watchman by taking the same 5mg in a 24 hour day.

Thank you, Susan. I appreciate your response. I wish you well as you recover from your latest ordeal. It sounds like you are in good hands.