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    Atrial Fibrillation and Heart Disease

    How Are Medications Used to Treat Atrial Fibrillation? continued...

    Rivaroxaban (Xarelto) is also approved to prevent stroke in patients with AF not caused by a heart valve problem. It also increases the risk for bleeding. But rivaroxaban can also increase the risk of stroke if people stop taking it without medical supervision. That's the main warning in the "black box" on the rivaroxaban label. A black box warning is the FDA's strongest warning. Rivaroxaban had previously been approved to prevent blood clots in patients receiving hip and knee replacements and in those with deep vein thrombosis.

    The usual dose of apixaban is 5 milligrams, taken twice a day with or without food. In a study of more than 18,000 patients comparing apixaban with warfarin, those on apixaban were less likely to have a stroke. In another study of people with AF who could not or chose not to take warfarin, apixaban was more effective than aspirin at preventing stroke.

    Edoxaban (Lixiana, Savaysa) is another anti-clotting drug FDA-approved to reduce the risk of stroke in patients with atrial fibrillation (not caused by a heart valve problem). Edoxaban given at the higher dose level was found to be equal to warfarin in preventing stroke, while demonstrating less major bleeding.

    Since anticoagulants lower clotting in patients, they carry a risk of causing excessive bleeding during non-stroke related injuries. The drug idarucizumab (Praxbind) can be used in emergencies to reverse the blood-thinning effects of the Pradaxa and thereby help stop the bleeding.


    Lifestyle Changes for Atrial Fibrillation

    In addition to taking medications, there are some changes you can make to improve your heart health.

    • If you notice that your irregular heart rhythm occurs more often with certain activities, you should avoid them.
    • Quit smoking.
    • Limit your intake of alcohol. Moderation is the key. Ask your doctor for specific alcohol guidelines.
    • Some people are sensitive to caffeine and may notice more symptoms when using caffeinated products (such as tea, coffee, colas, and some over-the-counter medications). Consider limiting caffeine intake if you feel that it increases your symptoms.
    • Beware of stimulants used in cough and cold medications. Some of these types of drugs contain ingredients that promote irregular heart rhythms. Read the label and ask your doctor or pharmacist what type of cold medication is best for you.
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