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What Do Persistent Rashes On The Skin While On Blood Thinners Indicate?

Posted on Wed, 19 Apr 2017

Question: Mother has been on several blood thinning medicines, each with adverse affects, for afib. The latest was eliquis which she had persitant rash to the point of disabling of daily living! She stopped taking the 5mg Eliquis one week ago. Within days the rash disappeared. She is 86 years old and uses a walker. Her cardiologist wants her to try Savaysa which she has refused to do so. I am giving her 325 mg safety coated aspirin, 2 g Salmon oil, 400 iu vitamin E, 1g garlic oil. Her CRP at the march 24th check was 40.64 mg/l , Cholesterol 124, INR 1.2, prothrombin time 11.8 sec. Given her high CRP, I want to add bromelian 500mg. Is this advisable? Also she was on Crestor for years for cholesterol, she has recently stopped it for allergy testing. With her cholesterol within normal parameters, do you think she would have to resume taking it? Would it also be advisable to give her 100 mg of coq 10? My main goal I think should be on stroke prevention and heart restoration. Am i giving her too much? I might add she takes 240mg Cartizem and 10 mg Norvasc and 50 mg Synthroid. She also takes 1000 mg vitamin C daily to help reduce her inflammation.

Answered by Dr. Olsi Taka (3 hours later)

Brief Answer:
Can be taken, stroke prevention remains inadequate though

Detailed Answer:
I read your question carefully and I understand your concern.

Regarding the blood thinner issue I must say that I tend to agree with cardiologist. Aspirin doesn't provide adequate protection in atrial fibrillation patients, an anticoagulant is needed. I understand that she fears another side effect like the rash she just had with Apixaban. However as you may imagine the consequences of a potential stroke might be far more serious and risk permanent deficits.

Regarding bromelian use, when it comes to an evidence based assessment it is not an approved product as there are not high quality studies regarding its benefits or side effects (those publications regarding its use in osteoarthritis are not quality ones in terms of methodology). However since it is a naturally occurring protein its use should be safe, you could try it.

Coenzyme Q10 may be added as well to help heart function. No benefit regarding atrial fibrillation and stroke prevention though.

I do not think that there is a risk from taking all those substances in terms of safety, apart from compliance issues, your mother not wanting to take so many products and risking to make confusion between them.

I remain at your disposal for other questions.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Olsi Taka (3 hours later)

Thank you so much for taking the time to answer. Unfortunately i cannot force her to accept the Savaysa. So I am doing the best I can with what I have available to me.

Answered by Dr. Olsi Taka (2 hours later)

Brief Answer:
Aspirin does provide some minimal protection.

Detailed Answer:
I understand your difficulties, it is obvious that you're trying your best.

Aspirin does provide some protection though not enough as I said, lowers risk by only about 20 compared to about 60% with anticoagulants. So still better than nothing. Perhaps in time once she has been side effect free for some time might be persuaded to accept anticoagulants.

Let me know if I can further assist you.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar