Sometimes, blood clots can form in the blood vessels of our body. This is a really dangerous situation. Because if these blood clots travel through the veins and reach the brain, heart, or lungs, they can cause very serious and even life-threatening conditions like stroke. This risk is especially high for someone with atrial fibrillation (Afib), an irregular heartbeat. So, your doctor may have given you a special medicine to reduce this risk. Today, we are talking about Edoxaban, a blood thinner that is prescribed to many people.
Simply put, what is Edoxaban?
Edoxaban is a medication prescribed by doctors to prevent blood clots. In everyday speech, we call these "blood thinners." But what actually happens is that rather than reducing the thickness of the blood, it interferes with the process of blood clot formation.
This medicine is mainly used for:
- Prevent and treat blood clots in the deep veins of the body (especially the legs) and lungs.
- Reduce the risk of stroke caused by blood clots in the brain in people with atrial fibrillation, an irregular heartbeat.
Simply put, this medicine is like a lifeguard that can help save your life.
Things you should definitely tell your doctor before starting this medication:
This is very important. Edoxaban is not a one-size-fits-all drug. Therefore, it is important for your doctor to know your complete medical history before prescribing this medication. If you have any of the conditions listed below, be sure to tell your doctor.
| Your medical condition or special occasion | Why should you inform the doctor? |
|---|---|
| Bleeding diseases or problems | Since this is a blood thinner, it may increase the risk of bleeding if you are already at risk. |
| Kidney disease | The drug is eliminated from the body through the kidneys. If kidney function is impaired, the dosage of the drug may need to be adjusted. |
| Liver disease | Since liver function affects blood clotting, the doctor should be aware of this. |
| If you have a prosthetic heart valve | Edoxaban may not be suitable for these situations. Other medications may be needed. |
| Antiphospholipid syndrome (APS) | This is a condition that increases the risk of blood clots and may require other treatments. |
| Cancer or ulcers in the stomach or intestines | The risk of bleeding from these areas may be increased. |
| If you are scheduled to have a spinal procedure such as surgery, epidural, or spinal tap in the future | This medication must be temporarily stopped before surgery due to the risk of bleeding. |
| If you are pregnant or trying to get pregnant | Taking this medicine during pregnancy may pose a risk of bleeding for both the mother and the baby. |
| If the baby is breastfed | You should talk to your doctor about whether the medication passes to the baby through breast milk and whether it will have any effects. |
| If you have an allergic reaction to other medications, foods, or dyes | This is important so that your doctor can get an idea of whether you may be allergic to this medicine or any of its ingredients. |
How exactly do I use this medicine?
To get the most out of this medicine, it is very important to take it correctly.
- Swallow the pill with a glass of water. Take it exactly as prescribed by your doctor.
- Try to take your medicine at the same time every day. Once you make this a habit, you will be less likely to miss your dose.
- You can take this medicine before or after meals. However, if you experience stomach upset, it is best to take it with food.
- Most importantly: To ensure the success of your treatment, do not skip any doses of your medication for any reason. If you stop taking your medication or skip a dose, your risk of blood clots or stroke may suddenly increase. Continue taking this medication until your doctor tells you to stop.
You may receive a special information leaflet (MedGuide) when you are given this medicine. It contains a lot of important information about this medicine. So be sure to read it carefully.
What if I take too much medicine?
If you have any suspicion that you have taken more than the prescribed dose of this medicine, immediately go to the nearest hospital Emergency Department (ETU). Or call the National Poisons Information Centre at the Colombo National Hospital .
What to do if you miss a dose of medicine?
We all forget things, so don't worry if you miss a dose.
- Take that time as soon as you remember.
- However, if it is almost time for your next dose (for example, if your next dose is due in a few hours), skip the missed dose and take your next dose at the scheduled time.
- Never take two meals at the same time. That means don't take two pills at once to make up for a missed meal.
What other medications may interact with Edoxaban?
This is also something to be very careful about. Edoxaban is a drug that can interact with many other medications. This can increase the risk of bleeding or reduce the effectiveness of the drug.
If you are using the following medications, it is imperative that you tell your doctor about them.
| Drug category | Examples and special notes |
|---|---|
| Medicines that should never be taken together | |
| Defibrotide | Taking Edoxaban with this drug greatly increases the risk of bleeding. |
| Other drugs that may interact | |
| Other blood thinners | For example: Warfarin, Enoxaparin, Dalteparin, Aspirin. Taking these together can greatly increase the risk of bleeding. |
| Painkillers (NSAIDs) | For example: Ibuprofen, Naproxen, Diclofenac. These also increase the risk of bleeding. Paracetamol is usually safe to take for minor pain, but ask your doctor about that too. |
| Some medications for depression (SSRIs/SNRIs) | For example: Fluoxetine, Sertraline, Venlafaxine. These can also affect the risk of bleeding. |
| Some antibiotics and antifungals | For example: Clarithromycin, Erythromycin, Ketoconazole, Itraconazole. These can affect the amount of Edoxaban in the body. |
| Some medications for heart disease | Eg: Amiodarone, Dronedarone, Quinidine, Verapamil. |
| Other medications | For example: Cyclosporine, Rifampin (a medicine for tuberculosis). |
Very important: This list is not complete. Tell your doctor about all the medications you take (including vitamins, herbal remedies, and dietary supplements) . Also, tell your doctor if you smoke or drink alcohol.
Things to be especially careful about when taking this medicine:
It is very important to think about your safety while taking this medicine, as you are at a slightly higher risk of bleeding than the average person.
Avoid dangerous actions and falls
If you fall or have a serious accident, you may experience internal bleeding that is not visible from the outside. Therefore,
- Stay away from sports that can cause accidents (e.g. rugby, football).
- Be very careful when using sharp weapons and knives.
- It is safer to use an electric razor instead of a razor.
- Use a soft-bristled toothbrush when brushing your teeth. Be very gentle when flossing.
Before surgery or tooth extractions
If you are having any surgery, tooth extraction, or minor procedure, tell your doctor or dentist in advance that you are taking Edoxaban. This medication will usually need to be temporarily stopped a few days before the surgery.
Risks of Spinal Procedures
Although this is very rare, it is important to be aware of it. If someone taking edoxaban receives an injection into the spine (e.g., epidural, spinal tap), there is a very small risk of a blood clot forming in the spinal cord. This can cause serious problems such as paralysis. If you experience back pain, numbness, or loss of feeling in your legs, tell your doctor right away.
Wearing an ID card
Wearing a medical ID bracelet or carrying a card stating that you are taking blood thinners could help save your life in an emergency.
What are the possible side effects?
Like any medicine, Edoxaban can cause side effects in some people. Although most of these are minor, there are some things we should be very careful about.
| Side effect | Symptoms you may see |
|---|---|
| Serious side effects that you should report to your doctor immediately | |
| Allergic Reactions | Skin rash, itching, swelling of the face, lips, tongue or throat (may cause difficulty breathing). |
| Bleeding |
|
| Bleeding in the Brain | Severe headache, stiff neck, confusion, dizziness, vision changes, numbness or weakness in the face, arm, or leg, difficulty speaking, difficulty walking. |
| Heavy periods in women | Menstrual bleeding that is heavier than usual or lasts longer than usual. |
If you experience any other unusual symptoms not mentioned on this list, talk to your doctor about them as well.
How do you store and dispose of medication?
- Storage: Store the tablets at room temperature (between 20-25 degrees Celsius). Keep them in a safe place out of the reach of children and pets.
- Expired medication: Do not use expired medication.
- Disposal: The best way to dispose of unused or expired medications is to donate them to a drug collection program. You can ask your hospital or clinic about this. If this is not possible, remove the pills from the container, mix them with something like coffee grounds, soil, or cat litter, put them in a tightly sealed bag, and throw them in the trash. Never flush them down the toilet.
Take-Home Message
- Edoxaban is a very important drug that prevents blood clots and protects you from serious conditions like stroke.
- Do not stop taking the medication or skip a meal for any reason without your doctor's advice.
- Tell your doctor about all other medications you are taking (including vitamins and herbal remedies).
- If you notice any symptoms such as unusual bleeding, bruising, or severe headaches, notify your doctor immediately.
- Tell the doctor you are taking this medicine before any surgery or dental treatment.
- If you have any questions about your health, discuss them with your doctor.
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