As part of an NHS budget saving scheme, We are switching patients on repeat from once daily edoxaban (Lixiana) costing around £600 each year per person to twice daily apixaban, costing under £50 per year.
Apixaban has the best evidence of safety and effectiveness in this family of medications and its patent has recently expired making it a better value replacement.
We fully support this switch, and are happy to discuss any concerns that arise.
Frequently asked Questions (FAQ)
When do I start the new medication?
Use up any existing supply of edoxaban. Take your last edoxaban in the evening as usual, then take the first apixaban tablet the next morning and evening.
Do I need a test to monitor this medication is working?
The same as with edoxaban: We usually just check your kidney function and weight each year. Sometimes we lower the dose in people with lower kidney function, especially if aged over 80 or weight under 60kg (below 9 and half stone).
Can I take apixaban once daily?
Apixaban must be taken as a twice daily medication. Another drug called rivaroxaban can be taken once daily, standard dose is 20mg once daily.
Rivaroxaban is also “off patent” and therefore much cheaper to prescribe as well.
We have preferred apixaban because there is some data to suggest it has better safety for bleeding risk compared to rivaroxaban, but the risks are still low for both.
There is not enough safety data to prefer edoxaban or rivaroxaban with regards bleeding risk, so we will advise rivaroxaban if you prefer once daily medication as the best value medication.
Will I get side effects?
Usually not. Bruising or Bleeding is a risk with all blood thinners. Apixaban has the best safety data for lower bleeding risk in this family of medications.
Another side effect is some tummy upset, sickness or diarrhoea. If you did have problems with apixaban (or rivaroxaban), we can swap you back to edoxaban.