Change to Your Anticoagulant Medication

Re: Change to Your Anticoagulant Medication

We are writing to inform you about a recommended change to your anticoagulant (blood-thinning) medication. Following a routine review of your treatment for atrial fibrillation (AF), in line with updated NHS England guidance, we propose switching your current medication, Edoxaban (Lixiana®), to Rivaroxaban.

Why Are We Recommending This Change?

  1. Equally Safe and Effective: Rivaroxaban works in the same way as Edoxaban to reduce stroke risk in AF. Both are recommended by the National Institute for Health and Care Excellence (NICE) and are widely used across the NHS
  2. Cost-Effectiveness for NHS Resources: Generic Rivaroxaban is now classified as a “best value” option by NHS England. This allows the NHS to allocate resources more efficiently while maintaining high-quality care
  3. Simplified Treatment Regime: Like Edoxaban, Rivaroxaban is taken once daily, so your routine will not change, however with Rivaroxaban it is important you take it with your main meal of the day, as food helps your body absorb the medication to ensure it is effective.

What Do You Need to Do?

  • We will arrange for your prescription to be updated to Rivaroxaban and send through a new prescription to your pharmacy.
  • If you have concerns about this change, or if you’ve experienced side effects with anticoagulants in the past, contact us to discuss further using an online consultation here https://bmg.link

Safeguarding Your Health

  • At least annual reviews of anticoagulant therapy are standard practice to ensure safety and effectiveness. All patients on these medicines need at least an annual blood test and weight check to ensure the dose prescribed is safe and appropriate for you. This switch aligns with that process. 
  • No additional monitoring is required beyond your usual check-ups. If you are over 75, current NHS guidelines recommend 4 monthly blood tests to keep an eye on your kidney function (This advice applies to All anticoagulants, including Edoxaban, Rivaroxaban, Apixaban)

Support for the Change

Your community pharmacy will be able to support you with this change under the New Medicine Service (NMS) and will be able to answer any questions you may have, but for most patients, they won’t notice any difference between these 2 medicines.

This adjustment reflects the NHS’s commitment to providing clinically effective care while ensuring resources are used responsibly for the benefit of all patients. Thank you for your understanding.

Yours sincerely,

Note: This letter follows NHS England’s September 2024 guidance on DOAC prioritisation (Table 1), which ranks generic Rivaroxaban as a joint top cost-effective option for AF see https://bmg.link/nhsdoac for detailed information.