Eliquis (known generically as apixaban) is a newer generation anticoagulant medication and is the most recent of three new drugs in the class, including Pradaxa and Xarelto. All three have been linked to an increased risk of uncontrolled bleeding - a common side effect for anticoagulant medications. But unlike warfarin (known by its brand name as Coumadin), none of the three newer drugs has an antidote to the uncontrolled bleeding.
“Eliquis was approved to prevent strokes, prevent blood clots, prevent pulmonary embolisms and strokes from atrial fibrillation,” Dr. Malik says. “It was introduced in 2012 and its makers - Pfizer and Bristol-Myers Squibb - kicked it off with direct consumer advertising. Its side effects are basically the same increased risk of fatal bleeding as Xarelto and Pradaxa.”
Similar to Pradaxa and Xarelto, Eliquis was marketed as being superior to warfarin because of the lack of blood monitoring required. But as Dr. Malik says, the lack of blood monitoring may be a small benefit when compared to the increased risk of uncontrolled bleeding.
“At the end of the day, neither Xarelto nor Eliquis has any improved benefit over warfarin when compared head-to-head in the prevention of stroke or deep vein thrombosis, but they have a higher bleeding profile because there is no antidote,” Dr. Malik says.
“The drugs were marketed as being ‘one dose fits all’ but that’s not necessarily true. Patients with kidney disease need a lower dose and unless you have the blood thinning tested, there is no way of knowing if someone is being over- or under-prescribed the drug. Then there is no way of knowing how good Eliquis is compared to warfarin.”That combined with the lack of an antidote means that Eliquis may have risks that are too high compared with warfarin, an older and less expensive medication, without any increased benefit.
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“There is no litigation at this time, but this is something to watch for,” Dr. Malik says. “Depending on how Xarelto goes, Eliquis could wind up with similar lawsuits. If the FDA ever mandates a blood test to measure the efficacy of Eliquis over warfarin, then the benefits will disappear because the patient will require regular blood monitoring. Patients will have all the side effects of Eliquis, with no benefit and the only real benefit - lack of blood tests - will be gone.”
READER COMMENTS
Jimbo
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Rojer
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Coy Moore
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The Dr. is forcing him to use the Eliquis, against his will, which has no antidote if uncontrolled bleeding ever occurs.
Also, the cost is way out of my parents budget as well.
lawrence moore
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