When To Stop Eliquis In Elderly?

I’ve taken Eliquis (apixaban) for years to prevent strokes from my atrial fibrillation (AF). It has been a lifesaver, keeping me safe from blood clots. But, there might be a time when stopping it is best, especially as I get older and my health changes.

Stopping Eliquis is a big decision that needs careful thought with my doctor. We’ll look at my health, stroke and bleeding risks, how well I can take the medicine, and what I prefer. Even though Eliquis helps prevent serious events, it doesn’t always improve how I feel every day.

Key Takeaways:

Eliquis (apixaban) is an important anticoagulant medication for elderly patients with atrial fibrillation or other conditions requiring blood thinning.

The decision to stop taking Eliquis should be made carefully, considering the individual’s stroke risk, bleeding risk, overall health, and personal preferences.
Healthcare providers and patients must engage in shared decision-making to determine the appropriate timing for discontinuing anticoagulation therapy.
Clear guidelines and more research are needed to help guide the deprescribing process for oral anticoagulants in the elderly population.

Stopping Eliquis requires a thoughtful approach, balancing the benefits of stroke prevention with the potential risks and burdens of continued medication use.

Understanding Eliquis (Apixaban) for Elderly Patients

Apixaban as an Anticoagulant Medication

Apixaban, also known as Eliquis, is a new oral anticoagulant. It’s great for elderly patients with atrial fibrillation or venous thromboembolism. Unlike warfarin, apixaban stops coagulation factor Xa, a key clotting factor. This makes it safer for older adults who might bleed easily.

Studies show apixaban is great for the elderly. It cuts the risk of stroke and blood clots in atrial fibrillation. It’s also safer than aspirin for preventing strokes in older people.

But, stopping apixaban in elderly patients needs careful thought. Stopping it suddenly can increase the risk of blood clots. Unless it’s for serious bleeding, it’s best to switch to another blood thinner to keep stroke prevention going.

“Apixaban was consistently associated with the most favorable benefit-risk profile across geriatric subgroups, according to the statistical data presented.”

Healthcare providers can make better choices for stroke prevention in the elderly by understanding apixaban. It’s important to watch patients closely and adjust dosages as needed. This ensures apixaban is safe and effective for older adults.

Factors to Consider When Stopping Eliquis In Elderly

Deciding to stop Eliquis (apixaban) in elderly patients is a big decision. It needs careful thought because older people are more likely to fall and bleed. This can change the balance of risks and benefits of taking the medicine.

Healthcare providers must think about these important things when deciding to stop Eliquis in elderly patients:

Indication for Anticoagulation: Why the patient is taking Eliquis, like for atrial fibrillation or a mechanical heart valve, is key. It helps decide the risks of stopping the medicine.

Bleeding Risk: Older people are more likely to bleed, including in the gut or brain. This risk must be looked at closely.
Stroke Risk: Stopping the medicine can raise the chance of stroke, especially for those with atrial fibrillation. This risk must be balanced with the bleeding risk.
Functional Status: How well the patient can move, think, and follow their medicine is very important.

Shared Decision-Making: It’s important to talk with the patient and their family. This helps understand what they value and worry about.

Healthcare providers should also think about what the patient wants for end-of-life care. This might affect the choice to keep or stop Eliquis. Regular talks with the patient’s doctor are key to making the right decision for the patient.

Stopping Eliquis in elderly patients is all about balancing the good and bad sides. It’s about focusing on the patient and making decisions together. By looking at these factors, healthcare providers can help ensure the best care for their elderly patients.

Risks and Benefits of Discontinuing Anticoagulation

Weighing the Pros and Cons

Deciding to stop anticoagulation, like Eliquis (apixaban), in older patients is tough. The main aim is to prevent strokes. But, there are other key points to think about too.

Keeping up with anticoagulation therapy cuts down stroke risk. Research shows it can lower stroke risk by about two-thirds in those with atrial fibrillation. Yet, as we get older, the chance of bleeding grows. This is a big worry for elderly folks.

The HAS-BLED score is used to figure out the 1-year risk of major bleeding in atrial fibrillation patients on anticoagulation.
Older adults who often fall or are at high risk of falling face a 1.9 times higher chance of bleeding in the brain, no matter the antithrombotic therapy they use.

Stopping anticoagulation might let elderly patients enjoy more time with family without the hassle of strict diets, regular blood tests, and the fear of bleeding and bruising. There are also other ways to prevent strokes, like closing the left atrial appendage, that might be good for some older folks.

“Balancing the risk of stroke against the risk of bleeding due to falls is a common dilemma in older patients with atrial fibrillation.”

The choice to stop anticoagulation should be made together by the patient, their family or caregivers, and their doctors. By looking at the risks of stopping and the benefits of stopping, the team can pick the best option for the patient. They’ll think about the patient’s stroke prevention needs and bleeding risk.

When To Stop Eliquis In Elderly

As we get older, managing our medicines gets harder. This is true for drugs like Eliquis (apixaban), used to prevent strokes in older people with certain conditions. Deciding to stop or keep taking Eliquis is important for our older loved ones.

It’s important to think about the risk of stroke versus bleeding. Studies show that in people over 80, up to 23.5% of strokes are linked to atrial fibrillation. But, this group is also more likely to have serious bleeding issues with these drugs. Tools like the CHA₂DS₂-VASc and HAS-BLED scores help doctors figure out the risks.

When we’re older, making decisions together with the patient, their family, and doctors is key. We should talk about what the patient wants, their health, how long they might live, and what matters to them. Near the end of life, the risks of Eliquis might not be worth it, and stopping it might be the right choice.

Palliative care experts and primary care doctors are great at helping with these tough choices. They can guide patients and families. By talking openly and making decisions together, we can make sure our elderly loved ones get the best care for their situation.

Conclusion

Deciding when to stop Eliquis in elderly patients is complex. It depends on their health, risk of blood clots, chance of bleeding, ability to move, and what they prefer. Doctors should talk with patients and their families to make the best choice. This might mean keeping on Eliquis, switching to another drug, or stopping it.

It’s important to regularly check the good and bad sides of using Eliquis, especially when patients are near the end of life. By focusing on what the patient values and wants, doctors can make sure Eliquis use matches the patient’s health goals. This way, healthcare teams can make the best choices for stroke prevention in older adults.

FAQ

What are the considerations for stopping Eliquis (apixaban) in elderly patients?

Stopping Eliquis in elderly patients is a complex decision. It depends on the patient’s condition, risk of blood clots, and bleeding risk. It also depends on their ability to move and what they prefer. Doctors should talk with patients and their families to decide what’s best.

How does Eliquis (apixaban) work as an anticoagulant medication?

Eliquis works differently than warfarin. It directly stops coagulation factor Xa, which is important for blood clotting. It’s safer than warfarin when it comes to bleeding but might cause more minor bleeding than aspirin.

What are the risks of discontinuing Eliquis (apixaban) in elderly patients?

Stopping Eliquis can increase the risk of blood clots, like a stroke. If the patient isn’t stopping because of serious bleeding, they should get another blood thinner to lower stroke risk.

How should the decision to discontinue Eliquis (apixaban) be made?

Deciding to stop Eliquis should involve the patient, their family, and doctors. They should think about the patient’s health, how well they can move, and what they prefer.

When might it be appropriate to stop Eliquis (apixaban) in elderly patients?

If the main goal is to spend time with family without worrying about diet or blood tests, stopping Eliquis might be okay. Doctors should talk about other ways to prevent stroke, like closing the left atrial appendage.