Apixban

Can mechanical heartvakve patients switch from warfarin to Eloquis yet?


3 Comments

No

by AgentX86 - 2020-07-11 20:14:23

I doubt it'll ever happen.  It's my understanding that there isn't any known danger but, sadly, there hasn't been a clinical trial and there isn't any interest in doing one.  It is a safer drug, generally, particulalry for older patients, but there isn't enough money in it to pay for the trials. The fact that there is a generic coming out any time, now, it's a double whammy.

I couldn't afford it if it WAS approved

by Protimenow - 2020-07-12 04:22:38

AgentX86's comment is interesting. Perhaps no clinical studies are being done because the number of people who have mechanical valves is too low to justify the cost of testing and, perhaps, because animal testing  didn't show positive results. 

It could be, too, that patients (or their insurances) wouldn't be able to justify paying $16 or so every day (it's my understanding that the medication is to be taken twice a day, and costs about $8 a dose), versus less than 25 cents a day for warfarin, and a few dollars a month for  monitoring. 

The more expensive anticoagulants are doing plenty of business with people who have AFib, or who've had deep vein thrombosis, or pulmonary embolism, or other reasons to take an anticoagulant. They probably don't need to switch focus to a merket of mechanical valvers.

N.O.A.C's and Mechanical Heart Valves

by IAN MC - 2020-07-12 09:03:22

It is an over-simplification to put everything down to cost !

Four new anti-coagulants were launched in close succession and doctors, inevitably bracket them together as being a new class of drugs. The drugs were Pradaxa ( dabigatran), Eliquis ( apixaban ) , Xarelto ( rivaroxaban ) and another one which I can't remember !

A trial using Pradaxa on patients with mechanical valves had to be halted early because of the high incidence of clots and bleeding around the heart. The F.D.A. issued a " black box warning " .... all serious stuff.

Hopes that N.O.A.C's would be an alternative to warfarin for mechanical valve patients were  dashed.

I do believe that Drs involved in trials are now very reluctant to use Eliquis or any of the N.O.A.C.s  in mechanical-valve patients  .It is a risk they are not willing to take .  It may take a long time to remove this fear following the Pradaxa trial, irrational as it is....  ( but, having to use warfarin isn't TOO  bad and it may be the safest option for you , Donna ! )

Ian

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