Half dose: Stvhan I am 85, weigh... - Atrial Fibrillati...

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Half dose

Stvhan profile image
12 Replies

Stvhan

I am 85, weigh 140lbs, have afib since 2015. Doctor prescribed eliquis 5mg twice a day,bruised easily, so l cut the pill and take half a pill twice a day for over a year, to minimize side effact and cost. i feel alright so far. Is this good or bad? Any comments will be appreciated.

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Stvhan
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12 Replies
CDreamer profile image
CDreamer

Hi and welcome. 5mgs is the normal dose - I know that for some of the AntiCoagulants the dose is reduced for people over 80 but not sure of Apixaban - but have you looked at the leaflet?

It’s a good question and perhaps one you need to ask your doctor as it is always a balance between risk of bleed and being on an efficacious enough dose to prevent a clot forming. People’s individual circumstances will vary and your docotor will have your full history. On the other hand, doctors are not infallible and it’s always good to check and question.

Best wishes.

10gingercats profile image
10gingercats in reply to CDreamer

Yes. It is recommended to reduce to half Apixaban dose at c 80. Just had mine reduced.

Some people have a half dose earlier than 80 if they are esp. light in weight my doc. told me.

brit1 profile image
brit1 in reply to 10gingercats

just saw your earlier post. I am also 80 but don't meet the other requirements for lowering dose to 2.5mgs (like only weighing 132lbs, I weigh 147lbs as I am tall) so am curious if you meet their weight requirement? I lowered mine because I am fearful of brain bleeds plus I eat a very good diet with added fish oil/garlic etc.

10gingercats profile image
10gingercats in reply to brit1

Yes. I do meet the weight/height requirements and as far as I know my kidneys and liver are in ok nick so I would like to keep it that way.

CDreamer profile image
CDreamer

bnf.nice.org.uk/drug/apixab...

I rather think if you are over 80 the advisory dose may be 2.5mg x 2 daily but there is a 2.5mg tablet so you don’t need to cut them in half.

May I suggest you go and have a conversation with your prescribing doctor and remind them if your age and check with them which dose is best for you.

Stvhan profile image
Stvhan in reply to CDreamer

In US eliquis is very expensive, with my insurance, 60 2.5mg eliquis cost the same as 60 5mg.

CDreamer profile image
CDreamer in reply to Stvhan

Aaah - we never have to think about cost. And doesn’t make any sense, outraged on your behalf.

Hello Stvhan, I’m not medically trained but it is my understanding that the dose for Apixaban is halved for the over 80’s for two main reasons.

First it is important that the kidneys and liver function properly as they (particularly the kidneys) enable the drug to be discharged from the body. Secondly, as we age, body tissue becomes thinner and falls become more frequent therefore the balance of a bleeding risk increases and this has to be weighed up against the risk of stroke. If I were you, I would discuss this with your doctor, but I believe halving the dose is normal practice.....

Stvhan profile image
Stvhan in reply to

Very helpful thank you.

Enjoy profile image
Enjoy

I am 84 and on the full dose. You have to meet two of the criteria to have the reduced rate of 2.5 i.e. be over 80 ....weigh less than 60 kg....have a severely reduced kidney function. I currently only classify by age but weight is very very slowly coming down. Still a bit chubby.

The patients leaflet was dated last year.

JaneFinn profile image
JaneFinn

Hi Stvhan, totally understand and sympathise with your reasoning of halving the price rather than getting the lower dose prescribed.

But just a thought - does it say on the patient leaflet (or have you checked with a pharmacist) if it ‘works’ to cut up/halve these tablets? I’m sure that I’ve heard that with some tablets that aren’t designed to be split, the active ingredients aren’t distributed evenly through the tablet. Though that might be a myth - as lots of tabs (eg bisoprolol) I do happily cut in order to use a fraction of the full dose.

I have no medical knowledge, I’m just flagging it up in case it might be worth checking. Or if someone on here maybe has the answer?

Stvhan profile image
Stvhan in reply to JaneFinn

That’s very good point, thank you so much. I’m going to ask my pharmacist for my next refill .

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