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Adults With ITP
Newly Diagnosed & Frequently Asked Questions
ITP and Eliquis.
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ITP and Eliquis. 4 months 3 weeks ago #72640

  • DRoberts264
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I have been receiving treatment for the past 9 years on N-Plate. I recently was diagnosed with A-Fib and cardiologist prescribed Eliquis 5mg twice daily. Since I have been on Eliquis I have had several bleeding episodes most recently having to have a wisdom tooth extraction and was off Eliquis for about 10 days the resumed. I then developed a bleed 15 days post-op on my gums. Does anyone have any idea  if having a lower platelet count, mine is between 80-100 that risk for stoke is less than normal and maybe I could drop the Eliquis?
Thanks, Andy

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ITP and Eliquis. 4 months 3 weeks ago #72642

  • MelA
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Andy we can't tell you if you could drop Eliquis - that is up to your doctors!   Has your hematologist and your cardiologist gotten together regarding your meds and the bleeding episodes?  I would have them communicate.  What you have asked us is what you should be talking to them about.

I'm sorry A-Fib has been added to the mix - sure hope all goes well for you!!
"Instead of wasting your time worrying about symptoms, just get it checked out" -Nieca Goldberg, MD

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ITP and Eliquis. 4 months 3 weeks ago #72644

  • mrsb04
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  • ITP since 2014. Retired nurse. My belief is empower patients to be involved as much as possible in their care. Read, read, read & ALWAYS question medics about the evidence base they use.
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Andy
Mel is correct this should  be a medical decision however it is your body and ultimately you have the final say.
Decisions regarding one's condition should be  informed, 2 way discussions between patient and doctor. 
Below are a couple of links (both well referenced papers) that may be of use to you 
ashpublications.org/thehematologist/article/doi/10.1182/hem.V15.3.8503/463004/The-Use-of-Anticoagulation-in-Patients-With 
www.ahajournals.org/doi/10.1161/JAHA.119.012596

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ITP and Eliquis. 4 months 2 weeks ago #72645

  • JJ
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They found out a few years ago that having ITP means we are more prone to clotting events, even with low counts. So do your research before making any decision.

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ITP and Eliquis. 4 months 2 weeks ago #72646

  • MelA
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JJ are ITPers more prone to clotting events?  I didn't know that and will ask my hematologist when I next see him - he loves blood and knows an awful lot about ITP (more than most of the hematologists I've had).   I do know that a lady in a group here that used to meet had a stroke with a count around 5k.  I was told just because one has low platelets doesn't mean one can't have a stroke.  I also know one should not go from a low count to a very high count because that can/will cause a stroke.  (I was given baby aspirin for a couple weeks after each knee replacement to avoid a stroke)

Long time ago there was a thread asking if anyone had had a clotting problem - I think most of those that answered were taking a couple treatments, but won't swear that since it was a while back.  
"Instead of wasting your time worrying about symptoms, just get it checked out" -Nieca Goldberg, MD

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ITP and Eliquis. 4 months 2 weeks ago #72648

  • mrsb04
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  • ITP since 2014. Retired nurse. My belief is empower patients to be involved as much as possible in their care. Read, read, read & ALWAYS question medics about the evidence base they use.
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Mel I am surprised you have never been told that ITP carries a  higher risk of clotting than in none ITPers. When I was diagnosed my GP read up on ITP as she had never had a patient with it. The first thing she said to me was never ever  get dehydrated now you have ITP. 
ITP caused by platelet destruction leads to a lower  platelet life span than that of  people without ITP therefore platelets do not reach maturity.
Immature  platelets are larger and stickier than mature ones therefore the risk of clotting is increased.
There are also theories surrounding micro particles of platelets circulating that could also lead to clotting. I am sure there was a post by Rob 16 about this a few years back. 
I have read papers that suggest TPORAs and IVIg carry an increased risk of clotting. This seems logical, assumimg  the person responds to treatment they would have a larger amount of immature platelets. 

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ITP and Eliquis. 4 months 2 weeks ago #72654

  • MelA
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Nope, never heard of that being the case mrsb.   I do know that our platelets are young and sticky and big - but not that I'm more likely to have a stroke than my non-ITP neighbor.  I do know that we shouldn't be having our count go real high as chances for a stroke are higher.
"Instead of wasting your time worrying about symptoms, just get it checked out" -Nieca Goldberg, MD

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ITP and Eliquis.

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