Dear Dr. Roach: In 1998, I was diagnosed with lupus anticoagulant and was put on Coumadin. I tolerated it well. A couple of years ago, I was changed to Eliquis, which I also tolerate well.

I noticed that when I was on Coumadin, I would find bruising on me that I didn't realize I had until I saw the bruising visually. With Eliquis, I don't notice the same sort of incidental bruising. My doctor attributed the difference to the nature of the medicines and the way they work. Do you concur with this observation?

— L.J.

Dear L.J.: In general, fewer people notice bruising on directly acting oral anticoagulants (DOACs) like apixaban (Eliquis) than with the older warfarin (Coumadin). Part of this may be that the levels of apixaban are very consistent, while the dose of warfarin often needs to

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