Viewing a single comment thread. View all comments

raptorbluez t1_j7vw278 wrote

The big question is an aspirin regiment as effective as Eliquis?

Eliquis has the most total cost the U.S. government, nearly $10 billion in 2020, not to mention its extreme cost for patients.

If low dose aspirin is as effective it will save a boatload of cash for both the government and for patients.

17

Edges8 t1_j7wep7y wrote

eliquis isn't typically used for DVT prophylaxis, but rather in those who have a known DVT/PE or in those with risk of stroke for AF, as two common examples.

a better question would be if asa could prevent DVTs in the general hospital population, and not simply young healthy trauma patients

17

[deleted] t1_j7xm656 wrote

[deleted]

4

Medical_Bartender t1_j7y3ywq wrote

Aspirin does lower stroke risk its just not as effective as anticoagulation. For people with increasing risk, anticoagulation is recommended (chads2vasc of 2 or more)

4

SippyTurtle t1_j7zv9iz wrote

It lowers the risk but it's not specifically because of AF. It's more targeting atherosclerosis rather than the clots formed in AF.

1

Pandoras_Cockss t1_j7w795o wrote

Ig it depends on how big the regiment is and how well they are equipped

1

Km2930 t1_j7wrudv wrote

No, the question is, which one leads to more bleeding.

0

Lawdoc1 t1_j7x04ar wrote

Came here to ask this very question.

1

rdizzy1223 t1_j7w010v wrote

Why does everyone only talk about low dose aspirin regiments rather than just normal/higher dose aspirin for more serious cases?

−3

pokey1984 t1_j7w5akn wrote

Because "more aspirin" doesn't thin the blood any more than a low dose.

After 81 mgs, you don't see any increase in the amount it thins the blood and higher doses over extended periods can be hard on the stomach and kidneys.

21

TinFoilHeadphones t1_j7w6nom wrote

81mg for what body weight?

2

Pro-Karyote t1_j7w865m wrote

For daily prophylactic use, it’s 81mg for all body weights (though the actual definition of low-dose aspirin is anything less than 100mg per day - 81mg is traditionally the dose for historical reasons).

Current Aspirin Guidelines

9

tjeulink t1_j7wl80m wrote

Historical reasons on medicine dosages? Now im interested haha

1

Pro-Karyote t1_j7wp06j wrote

It has to do with a unit of measurement we don’t currently use for dosing medications, called a grain. The full dose of aspirin was 5 grains, which is about 325mg. The low dose was a quarter of the full dose, so 1.25 grains (which is roughly 81mg). That was the dose that was on formulary, and since it falls within the low-dose range and it was the dose available, it stuck.

Brief overview of aspiring dosing history

12

TinFoilHeadphones t1_j7xgrnp wrote

Oh, that explains. I thought he said such a specific number as 81mg because of some calculations. I couldn't understand why such a weird number.

(I don't live in the USA, so measurements here are different)

1

pokey1984 t1_j7w9zb8 wrote

It's pretty universal. I'm sure some adjustments meed to be made for people who weigh like 600lbs, but for pretty much everyone else 81mgs is sufficient.

My mom is on Aspirin, Elliquis, and Warfarin for her heart problems because simply adding more aspirin or increasing either of the other drugs doesn't do enough. Most drugs reach a maximum effective level and after that more of the drug doesn't have any more effect. That's why people with serious problems will be on so many different medications instead of just taking a huge dose of one drug.

And in most cases, body weight is irrelevant. Certain drugs, yes, body weight matters. That's true of anesthetics and a few other types of drugs. But for most of them weight doesn't matter.

2

Lunaranalog t1_j7z6df9 wrote

Warfarin and Eliquis? Her cardio trying to make her bleed to death? That’s some serious dual therapy. I’ve never seen that. She must be a case study if that’s true.

3

pokey1984 t1_j81b0qv wrote

Not a case study, just bad heart/blood pressure issues. She's already had one stroke and two stents. She has A-fib and damage to one of her ventricles from an "undiagnosed" heart attack. (It wasn't diagnosed as a heart attack and she didn't have any symptoms of a heart attack, but she has damage that's evidence of a heart attack.) So they're trying to keep her heart from over working itself, trying to keep her arteries from clogging any worse, while trying to keep the stents from throwing any more clots while also not overwhelming her kidneys and liver.

So she's on a low dose of three blood thinners for the time being to try and protect her heart and lungs and eyes from further damage without destroying her kidneys.

2

Pro-Karyote t1_j7w5lvw wrote

Largely because there isn’t an increase in efficacy for higher doses of aspirin for prevention of cardiac or stroke events, but there is an increased risk of bleeding events with increasing doses according to several studies.

Effects of Aspirin Dose When Used Alone or in Combination With Clopidogrel in Patients With Acute Coronary Syndromes

Double-dose versus standard-dose clopidogrel and high-dose versus low-dose aspirin in individuals undergoing percutaneous coronary intervention for acute coronary syndromes (CURRENT-OASIS 7): a randomised factorial trial

4