Edoxaban Information
Why Are We Discussing a Possible Change in Your Medication?
As you may know, NHS resources are under increasing pressure. Like all NHS services, we have a responsibility to ensure we get the best possible value from every treatment we prescribe.
Edoxaban is a medication commonly prescribed for some patient groups to reduce the risk of stroke. However, two very similar medications – Apixaban and Rivaroxaban – now offer significant cost savings for the NHS.
Current Cost Comparison
- Edoxaban: approximately £49.00 per month
- Apixaban / Rivaroxaban: approximately £2.84 per month
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What About Effectiveness?
There are no direct head-to-head trials comparing these medicines. However, the available evidence shows that Apixaban, Rivaroxaban, and Edoxaban are all equally effective at preventing strokes in people with Atrial Fibrillation.
This is supported by guidance from the National Institute for Health and Care Excellence (NICE) – specifically NICE TA355.
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But I Only Recently Switched to Edoxaban…
When Edoxaban was first introduced, it offered the best value at the time, so many patients were switched to it from other medications. However, recent changes in pricing mean that Apixaban and Rivaroxaban now represent much better value, with potential cost savings of up to 90%.
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What Does This Mean in Real Terms?
To give you an idea of the potential impact:
In Hampshire and the Isle of Wight, switching patients to more cost-effective options could save around £6.5 million.
These savings could be reinvested in vital NHS services right here in your local area – supporting care, treatment, and resources for our community.
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How Will the Change Work?
We aim to make the switch as simple and safe as possible. Below are the three anticoagulant options, with dosing adjusted for renal function where indicated.
Preferred Option – Apixaban
- Taken twice daily, around 12 hours a part
- Does not need to be taken with food
- Easier to fit around your daily routine
- Has a lower risk of major bleeding compared to Rivaroxaban
- Dose adjustments are sometimes needed based on kidney function – your doctor will advise
- Switching is simple: just finish your current supply of Edoxaban, then start Apixaban the next day
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Alternative Option – Rivaroxaban
- Taken once daily, but must be taken with a full meal
- Timing is very important – skipping food can affect how well it works
- Slightly higher risk of bleeding compared to Apixaban
- Also available in adjusted doses if needed based on kidney function
- You can switch by finishing your Edoxaban, then starting Rivaroxaban the next day with a meal
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Current Therapy – Edoxaban
- Taken once daily
- Dose is also adjusted based on kidney function
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For Patients with Swallowing Difficulties
Both Apixaban and Rivaroxaban can be crushed and mixed with a small amount of water or apple sauce, just as you may have done with Edoxaban.
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Want to Read More?
Here are links to official patient information leaflets:
Warning advice: Patient information
What are Direct Oral Anticoagulants (DOACs) and how do they work?
Page about stroke risk with Atrial Fibrillation
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What If I’m Not Happy to Switch?
We hope this information has reassured you that this switch is safe, effective, and supports your local NHS.
However, your consent is essential – we will not make any changes to your prescription without your agreement. If you have concerns or questions, please speak to a member of the practice team.