Dear Doctor: Are there generic versions of medications for patients with atrial fibrillation?

DEAR DR. ROACH: My husband is taking Eliquis for atrial fibrillation (AFib). The cost is going up, and there is no generic brand for Eliquis. Looking at drug websites, I have found other drugs that are anticoagulants: Xarelto, heparin and warfarin are a few. Is there a generic brand you would recommend that we can ask his doctor about to see if they will let him take that instead? — C.A.

ANSWER: Most people with AFib benefit from anticoagulants to reduce the risk of stroke. The vast majority of people with AFib without valvular disease will take either a direct-acting oral anticoagulant (DOAC) such as apixaban (Eliquis), dabigatran (Pradaxa), edoxaban (Savaysa), rivaroxaban (Xarelto) or warfarin (Coumadin). Most experts choose one of the DOACs over warfarin because they have been proven to have lower risk of both stroke and major bleeding, compared with warfarin. Also, warfarin has to be carefully monitored by blood testing of the clotting time. People with some types of heart valve disease require warfarin therapy. Generic forms of DOACs have been approved by the FDA, but are not available in pharmacies at the time of this writing.

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