RAMBLE - Rivaroxaban vs. Apixaban for Heavy Menstrual Bleeding

Inclusion Criteria:

- Non-pregnant women, age 18-50,

- Objectively diagnosed VTE or atrial fibrillation within the previous 30 days, and no
menstrual cycle since diagnosis

- Patient reported active menstruation, requiring >3 menstrual periods in the previous 6
months

- Clinical plan and patient agreement to treat with oral anticoagulation for 3 months or
longer

- Patients must have a working mobile phone

Exclusion Criteria:

- Package insert exclusions for Eliquis (Apixaban) or Xarelto (Rivaroxaban): [active
pathological bleeding or severe hypersensitivity reaction to XARELTO or ELIQUIS (e.g.,
anaphylactic reactions)]

- Plan to become pregnant in the next three months.

- Concomitant prescribed use of aspirin or thienopyridine or other platelet inhibiting
drugs

- Plan for surgical hysterectomy or endometrial ablation

- Known uterine cancer

- Von Willebrand's disease, or hemophilia

- Known coagulopathy from liver disease

- Conditions likely to preclude adherence to study procedures: Active intravenous drug
use, known alcoholism, homelessness, or uncontrolled psychiatric illness.