Eliquis vs Warfarin

Eliquis vs Warfarin – detailed comparison:

Eliquis (Apixaban)

It is a blood thinner marketed and manufactured by Bristol-Myers Squibb, an American pharmaceutical company with headquarters in New York City, USA.

This medicine is used to lower the risk of stroke caused by a blood clot in individuals with atrial fibrillation, a dangerous heart rhythm disorder. This medication is advertised as the most effective in its class at reducing bleeding common with anticoagulants and preventing strokes.

Furthermore, it is given to reduce or treat the risk of developing a pulmonary embolism and deep vein thrombosis (a blood clot that typically occurs in the leg).

Notes – Even if it’s usually called a blood thinner, Apixaban doesn’t really thin the blood. Instead, it helps to break up or prevent dangerous blood clots which form in the heart or blood vessels. This medicine typically comes in tablet form and is usually taken twice per day without or with food.

Uses

It is used for reducing the risk of strokes and blood clots in the heart in sufferers with atrial fibrillation who don’t have nonvalvular atrial fibrillation (problems with the heart valves).

It is also used to treat blood clots in the veins of your lungs (pulmonary embolism) and legs (deep vein thrombosis), as well as it lowers the chance of them occurring again.

Also, it is used to reduce the risk of forming a blood clot in the lungs and legs of patients who have just had knee or hip replacement surgery.

Side Effects & Precautions 

The most frequent side effect which occurs with this medicine is bleeding.

Signs and symptoms may include:

• bleeding of the gums when you brush your teeth;
• heavy menstrual bleeding;
• bruising more easily;
• nosebleeds.

Serious side effects (very rare) include:

• signs of anaphylaxis (a life-threatening allergic reaction) that may consist of – swelling of the tongue, lips, face, or throat, hives, or difficulty breathing;
• chest tightness or pain;
• joint pain;
• rash;
• severe weakness;
• dizziness;
• headaches;
• trouble breathing;
• vomit which looks like coffee grounds;
• coughing up blood;
• bloody stools;
• brown or red urine;
• bleeding that won’t stop.

You may have an increased chance of bleeding if you take Apixaban and take other meds which increase the risk of bleeding, such as:

• serotonin-norepinephrine reuptake inhibitors;
• selective serotonin reuptake inhibitors;
• any medication which has heparin (a naturally occurring anticoagulant made by mast cells and basophils);
• Jantoven;
• Coumadin;
• long-term use of nonsteroidal anti-inflammatory drugs;
• aspirin.

It is recommended to tell your healthcare professional if you have heavy bleeding anywhere in your body that cannot be stopped or if you have an artificial heart valve (a device implanted in the heart of a sufferer with valvular heart disease). Your healthcare professional will most likely tell you not to take this medicine.

Premature discontinuation of any oral anticoagulant medicine, including Apixaban, in the absence of a correct alternative anticoagulation medicine, increases the risk of thrombotic events (the formation of a blood clot inside a blood vessel) considerably.

There are not sufficient studies to recommend the use of Apixaban in adolescents and children under the age of 18 years.

Drug Interactions

It can interact with the following drugs:

• Advil (ibuprofen);
• Plavix (clopidogrel);
• Aleve (naproxen);
• Celebrex (celecoxib);
• aspirin;
• amiodarone (a medication that is used to treat irregular heartbeats).

Alcohol

Avoid the intake of alcoholic beverages while taking this blood thinner medication.

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Warfarin (Coumadin)

This drug is usually sold under the brand name Coumadin in the United States. It works by stopping the body from forming blood clots.

It does this by blocking the formation of blood clotting factors (enzymes that use vitamin K to produce clotting factors), that are needed to make clots.

This is a serious condition. For example, these blood clots can break off and become lodged in the blood vessels of the lung, causing chest pain and even life-threatening shock.

This medicine comes in tablet form. However, it is also available in an injectable form to be infused into a vein by a doctor at a hospital. It is usually taken once per day, commonly in the evening. It is vital to take the dose at the same time every day, after, before, or during a meal.

Uses

It is commonly used to prevent deep vein thrombosis that may occur following major hip or gynecologic surgery because, after these interventions, the patient requires prolonged immobilization.

Moreover, this medicine also prevents blood clots from developing in people who have an increased risk of atrial fibrillation, rheumatic heart disease, as well as it is used after the insertion of artificial heart valves.

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Side Effects & Precautions

Frequent side effects of using this medicine may include:

• altered sense of taste;
• gas;
• bloating;
• weakness;
• dizziness;
• headaches;
• vomiting, nausea, and mild stomach pain.

Serious side effects (very rare) include:

• bruising, which develops without an injury;
• vomiting of blood;
• joint pain;
• stomach pain;
• bloody stool;
• brown or red urine;
• severe bleeding, especially more massive than normal menstrual bleeding.

This medicine prevents blood from clotting, therefore, it may take longer than usual for you to stop bleeding if you are injured or cut.

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Pregnancy

It may cause miscarriage, congenital disabilities, or the death of an unborn baby. Hence, don’t use Coumadin if you are pregnant unless you have a mechanical heart valve and your doctor recommends you to take it.

Bottom Line – Eliquis vs Warfarin

Both these meds are effective anticoagulants. However, while the new medicine (Eliquis) offers some health benefits over warfarin, some patients who require anticoagulants may do better to stay on the old medicine, especially if they didn’t experience any side effects.

Images credit – Shutterstock

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References

https://www.nejm.org/doi/full/10.1056/NEJMoa1107039
https://www.ajmc.com/conferences/acc-2018/large-claims-study
https://www.acc.org/latest-in-cardiology/clinical-trials/2013/07/19/12/07/aristotle