Thank you for the suggestion, I will definitely give it a try.

I take Xarelto and HU for PV. When I first started it, I would take 500 mg in the morning. I was awfully tired. About a couple of weeks later, I switched the time to around dinner or just after. That was a game changer. The fatigue decreased until my body adjusted and even the fatigue went away. At least from the HU.

When my hematologist wanted to increase the dose, I was very concerned about the fatigue returning. Thankfully, the two increases she made to my daily dosage was smooth and no fatigue. I now take 500 mg, twice a day Mon -Fri and only 500 mg in the evening on Sat and Sun.