Our videos about anticoagulants and atrial fibrillation
Our team have developed a series of short videos about the use of anticoagulants in atrial fibrillation.
Introducing atrial fibrillation
Everything you need to know about taking anticoagulants in atrial fibrillation (AF).
Anticoagulants in atrial fibrillation – video transcript
Anticoagulants are commonly prescribed in AF, but it can be hard to remember everything you are told in an appointment.
That's why we've developed a series of short films 'Understanding my medicine: anticoagulants for atrial fibrillation'.
The films tell you everything you need to know about AF and anticoagulants including: what AF is, how the medication works, how to take it, what else you can do to stay healthy.
What is atrial fibrillation?
This video explains what atrial fibrillation is and the symptoms it can cause.
What is atrial fibrillation? Video transcript
Atrial fibrillation commonly called AF is an abnormal heart rhythm it can sometimes cause the heart to beat too fast.
The heart has a natural timer that sets a regular beat. This starts in the upper chambers and then moves down to the lower chambers. In AF the natural rhythm is taken over by random electrical impulses in the upper chamber of the heart. This causes the heart to pump in a less regular and less efficient way.
If you have AF a disorganised heartbeat may give you symptoms. Sometimes these might be breathlessness, or little dizziness, or perhaps tiredness. Some people are aware of the heart fluttering or beating erratically. Some people don't have any symptoms at all. The symptoms may last for a few seconds or a few minutes or sometimes even longer.
AF is a very common heart rhythm and affects more than a million people in the UK. In itself it isn't usually life-threatening but we do tend to treat it as it does affect people's day-to-day life.
Why do I need to take anticoagulant medicine?
This video explains why your doctor may recommended that you take anticoagulant medicine.
Why do I need to take anticoagulant medicine? Video transcript
One of the main problems with having atrial fibrillation, commonly called AF, is that it does increase the risk of having a stroke.
The risk of having a stroke with AF could be increased by up to five times.
Strokes associated with AF can be more severe than strokes by other causes.
When the heart beats irregularly, it increases the chances of a blood clot forming within the chambers of the heart.
Although this is very rare, it can occur, and if it does and the blood clot is dislodged, it's a matter of chance where that blood clot would end up in the bloodstream.
If the blood clot happens to end up in a blood vessel going to the brain, this can cause a stroke.
The good news is that today, we have medications that can dramatically reduce the risk of a stroke in AF.
These medications, called anticoagulants, stop blood clots forming in the heart.
If you have AF, your doctor will assess your risk of stroke using a scoring system.
This takes into account your age, gender and other medical conditions such as diabetes and high blood pressure.
If you are at risk of AF-related stroke, your doctor may recommend treatment with either warfarin or a direct-acting anticoagulant.
These medicines really work.
How does my anticoagulant medicine work?
This video explains how anticoagulant medicine works and how to know if it is working.
How does my anticoagulant medicine work? Video transcript
Direct-acting anticoagulants work on the system that creates blood clots.
These medicines are as effective at preventing strokes compared to other anticoagulants such as warfarin.
Direct-acting anticoagulants work quickly. This means you are protected against strokes as long as you continue to take your medication regularly as your doctor has prescribed.
You do not need to have a regular blood test to check that the medication is working.
Bleeding is the most common side effect, however the effect of the medication wears off quickly.
If you did have a serious bleed there are things that we can do in hospital to stop the bleeding.
Your GP will order routine blood tests at least every year, and check for side effects.
How do I take my anticoagulant medicine?
This video explains the different types of anticoagulant medicine, and how to take them.
How do I take my anticoagulant medicine? Video transcript
There are four direct-acting oral anticoagulants available in the UK.
Apixaban, also known by the brand name Eliquis, is taken as one tablet twice a day, 12 hours apart. It can be taken with or without food.
Dabigatran, also known by the brand name Pradaxa, is taken as one capsule twice a day, 12 hours apart. It is recommended that you take this with food to prevent any stomach irritation.
Edoxoban, also known by the brand name Lixiana, is taken as one tablet daily, at approximately the same time each day. It can be taken with or without food.
Rivaroxaban, also known by the brand name Xarelto, is taken as one tablet once a day, at about the same time every day. It is best taken with a meal or snack
Whichever medicine you are taking, swallow it whole with a drink of water.
If you're having problems swallowing it whole, speak to your doctor or your pharmacist.
The dose that you are prescribed is dependent on your individual circumstances, based on your age, how heavy you are, how well your kidneys work, what other medicines you're prescribed and other health conditions you have.
If you are unsure about your dose speak to your doctor, pharmacist or nurse.
These medicines provide you with ongoing protection against stroke, and need to be taken long term.
You do not require regular blood tests to check if the medicine is working, but it's importantly continue taking them regularly and do not stop taking them unless your doctor tells you to do so.
What if I miss a dose of my anticoagulant medicine?
This video explains what do if you miss a dose of your anticoagulant medicine.
What if I miss a dose of my anticoagulant medicine? Video transcript
It's important to take your anticoagulant medicine regularly. That's because missing a dose makes it more likely that you can develop a blood clot or have a stroke.
What you do when you miss a dose depends on the medicine that you are taking.
If you are taking a Apixaban and miss a dose, take it as soon as you remember. Take your next dose at the usual time and continue as normal. Never take two Apixaban tablets together to make up for a missed dose.
If you are taking Dabigatran and miss a dose, take it as soon as you remember, as long as this is more than six hours before your next dose is due. If your next dose is due in less than six hours, take your next dose at the usual time. Never take two Dabigatran capsules together to make up for a missed dose
If you're taking Edoxaban and miss a dose, take it as soon as you remember, and then take it at your normal time the next day. Only take one Edoxaban tablet each day. Never take two tablets to make up for a missed dose.
If you're taking Rivaroxaban and miss a dose, take it as soon as you remember, and then take it at your normal time the next day. Never take two tablets to make up for a missed dose, and only ever take one Rivaroxaban tablet a day.
If you ever forget one of your medicines and are not sure what to do, always speak to your doctor or pharmacist.
Side effects of anticoagulant medicine
This video explains the common side effects of anticoagulant medicine and what to do if you experience them.
Side effects of anticoagulant medicine – video transcript
Bleeding is the most common side effect of anticoagulants, as it takes longer for your blood to clot.
If you have a significant blow to the head, or have been involved in an accident, you will need to go to your local A&E department.
If you notice any of the following, you will need to go to your GP or your local A&E department; nosebleeds that last for longer than 10 minutes, any unusual headaches, blood in your urine, stool or vomit, black stools or any unexplained or severe bruising.
If you cut yourself, apply pressure as you normally would. But it may take longer for the bleeding to stop. If the bleeding hasn't stopped within 10 minutes, go to your local A&E department.
We recommend that you carry an anticoagulation alert card at all times in case of emergency.
Any new medicine can make you feel nauseous or give you a stomach upset as a side-effect at first. It might help to take your medicine with food. If the side-effects persist for more than seven days, speak to your GP.
Lifestyle advice for taking anticoagulant medicine
This video provides advice on whether anticoagulant medicines are affected by diet and alcohol, and if they impact on your ability to exercise, have sex or travel.
Lifestyle advice for taking anticoagulant medicine – video transcript
You do not need to change what you eat when taking a direct-acting anticoagulant, but it is a good idea to maintain a healthy and balanced diet.
Direct-acting anticoagulants are not affected by alcohol. However, we do recommend that you try to stay within the safe limits. This is to reduce your risk of bleeding.
The safe limit is 14 units per week. One unit is one small glass of wine or one pint of low-strength beer.
Try to do physical activity and exercise for your general health and well-being. Exercise is an important part of keeping fit and healthy.
It is safe to exercise while taking an anticoagulant.
Avoid contact sports, such as rugby or hockey, as these can result in injury or bleeding.
Choose activities that you enjoy like walking, gardening, cycling, dancing or swimming.
If you are new to exercise, gradually build up the amount that you do,
Exercise until you feel slightly warm or slightly short of breath.
If you start feeling sick, dizzy or breathless, stop. Please do not overexert yourself.
There is no reason to avoid having sex. This medication will have no effect on your sex drive or sexual function.
There is no reason why you can't go on holiday while on this medication.
It is wise to take more tablets than you need in your hand luggage, and take a copy of your prescription with you. And remember, enjoy your holiday!
If you are not sure of any other lifestyle choices, or changes you would like to make, please get in touch with your doctor, pharmacist or nurse for advice.
Having an operation when taking anticoagulant medicine
This video explains what to do when having a procedure or operation when taking anticoagulant medicine.
Having an operation when taking anticoagulant medicine – video transcript
It is important to make sure that any other healthcare professionals involved in your care are aware that you are taking an anticoagulant.
This is especially important if you are going to have a procedure.
It may be a minor procedure, like going to the dentist or chiropodist, or it could be a major procedure where you're being admitted into hospital for an operation.
We recommend that you carry an anticoagulation alert card to show to healthcare professionals if you're going in for a procedure.
If you do not have an alert card, please get in touch with your pharmacist, as they will be able to provide one for you.
For some procedures and operations, it is required that you stop your anticoagulant temporarily.
For others, it is important that you stay on it.
Please check with your doctor or specialist nurse at least two weeks before your procedure.
What medicines should I avoid with anticoagulants?
This video explains which medicines to avoid taking with anticoagulant medicine.
What medicines should I avoid with anticoagulants? Video transcript
Your doctor, nurse or pharmacist will review your medications when you start on an anticoagulant to make sure that they don't interact.
This review will include any over-the-counter preparations, supplements, herbal or homeopathic medicines. However, please always check with your doctor, nurse or pharmacist when stopping or starting any treatment.
Whenever seeing any healthcare professional, such as your doctor, dentist, pharmacist or nurse, please let them know any medicines that you are currently taking.
It is best to avoid any medicines that can increase the risk of bleeding, such as aspirin, ibuprofen or any anti-inflammatories.
However, if your doctor advises you to take these, then follow their advice.
If you need anything for pain control, we would recommend paracetamol.
Can I take anticoagulant medicine whilst pregnant or breastfeeding?
This video explains whether it is safe to take anticoagulant medicine whilst pregnant or breastfeeding.
Can I take anticoagulant medicine whilst pregnant or breastfeeding? Video transcript
If you are taking an anticoagulant and you are planning to become pregnant, it's best to see your GP or cardiologist to discuss this in advance.
If you are not planning on having a baby and there is a chance that you could become pregnant, use reliable contraception.
If you do become pregnant whilst taking this medicine, let your GP know immediately.
We do not advise that you take this medicine whilst breastfeeding.
Speak to your GP, midwife or your cardiologist if you have any specific questions.
Where do I get my anticoagulant medicine?
This video explains how your anticoagulant medicine will be prescribed and what follow up you need.
Where do I get my anticoagulant medicine? Video transcript
If you start anticoagulation medication in hospital, then the hospital will dispense your first prescription.
After this, your GP will take over responsibility for prescribing your medicines in a safe way.
They will almost certainly ask you to come in and see them to discuss this further.
In some cases, your GP will initiate treatment with anticoagulation medication.
We often see patients fairly regularly at the start of treatment to make sure everything is okay.
We recommend that you carry an anticoagulation alert card with you at all times. If you lose this, then your community pharmacist can give you another one.
If you have any questions or queries about your medication, please ask your doctor or community pharmacist. We're there to help.