Hi I am a pharmacist and run an anticoagulantion service. My view is I would stick to warfarin I am very aware of its problems not only on a professional level but also a personal one as my husband has been on it for over 10 years post Aortic Valve replacing. (The new drugs such as Rivaroxaban can't be used for this as there is not enough confidence they are effective enough to prevent clots, the companies have not published any research into this area). I have come across a lot of problems with people on the new anticoagulants including a number of strokes, so quite a few are being switched back to warfarin - not particularly complicated just takes a few days.
As yet there is no antidote to rivaroxaban available in the NHS although there is talk of one soon (it is undergoing clinical trials at the moment) but soon can be quite a while in NHS terms and relies on any hospital you may end up in stocking it - not guaranteed at all. And certainly not in the next year or so.
Also I have studied the research into these new anticoagulants as I did a discertation on them last year for my Masters and there is a real concern from academics and many physicians about the non follow up of patients on these new drugs, the research was all based on patients who were tested as regularly as those on warfarin. And yet it had been marketed as needing no follow up, which is now being doubted quite strongly.
So basically you have a long established drug with well known issues which you are closely monitored on to ensure that your risk of stroke or bleeding is kept to a
Minimum, but can be easily and very rapidly reversed if serious problems occur or you need emergency surgery for anything. Or a new drug with little history and no testing to see how you as an individual are responding to it. Which can be great as it saves you going to your local clinic to have a finger prick every few weeks to check if you are on the optimal treatment. But in reality isn't the peace of mind you get from knowing it's working worth it.
With so many areas of health we are moving to an indivualised treatment, which we have with warfarin but the new ones are returning to a one size fits all scenario.
Having said that we really need people to be guinea pigs to try out these new drugs so that in the future we have much more information about them. Just so long as you feel fully informed and happy to be one of them.
The drugs companies are spending a vast amount of money promoting the new anticoagulants to health professionals where as, as warfarin is so long established it is well out of patent so there is no money from anyone to promote it.