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Dear Dr. Roach • I’m 83 and was afresh diagnosed with atrial fibrillation. My doctor put me on Eliquis. I accept had no problems with it, except the cost! Is there article commensurable that is beneath expensive? — D.C.

Answer • Apixaban (Eliquis) is one of the new articulate anticoagulant drugs, generally abbreviated “NOACs.” They are able and accept agnate or lower bleeding accident than the earlier treatment, warfarin, but apixaban does not accept an antitoxin in case of astringent bleeding, as I afresh addressed in a column.

I did not abode cost. The boilerplate retail amount for a month’s account of apixaban is $484, which is a huge accountability for abounding bodies if their allowance doesn’t awning it or alone partially covers it. Abounding insurers accept a accurate NOAC they will cover, and it may be that your prescriber can about-face you to the adopted drug. There are drug-assistance programs through the manufacturer; appointment its website at www.bmspaf.org.

If that still doesn’t help, again you can booty warfarin, which is actual inexpensive. However, the drug’s akin has to be monitored via claret tests on an advancing basis.

Dear Dr. Roach • I was diagnosed with a beddy-bye ataxia alleged “idiopathic hypersomnia.” My affection are agnate to narcolepsy: I abatement comatose afterwards warning. However, I can be woken. I abatement comatose anywhere from two to 10 times per day. I accept approved abounding medications, and annihilation has formed at all. I accept been told that annihilation can advice me with this attenuate beddy-bye disorder. Do you accept any suggestions? — A.B.

Answer • Narcolepsy is an abnormal condition, area bodies accept apathy during the day and usually accept cataplexy (sudden weakness brought on by emotions, such as afterwards laughing), hallucinations at the time of falling comatose and aeroemism for a few account on waking. What you accept been diagnosed with, idiopathic hypersomnia, is abundant rarer; I accept never apparent a case. Bodies with your action accept daytime apathy but don’t accept the cataplexy, although abounding bodies are abashed aloft actuality awakened. From what I accept read, medications for narcolepsy generally are approved (such as modafinil). From your description, it’s acceptable that you accept approved these kinds of medicines.

I did apprehend about flumazenil, an intravenous medication that is acclimated for balance of a specific blazon of sedatives, actuality formulated as a us and acclimated in idiopathic hypersomnia, so you ability ask your doctor about accepting into a abstraction on this medication.

Dr. Roach abjure that he is clumsy to acknowledgment alone letters, but will absorb them in the cavalcade whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.

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