If you are currently taking warfarin,... - Atrial Fibrillati...

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If you are currently taking warfarin, would you consider taking one of the newer oral anticoagulants instead?

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88 Replies
frenchgoose profile image
frenchgoose

I would consider one of the new anticoagulants....saves the endless trips to hospital for a check which must cost the NHS loads in testing. Concern is the reversal mechanism for a bleed.

shawnner profile image
shawnner in reply tofrenchgoose

I'm in the US and my Dr hooked me up with home testing. It's easy to take & report through their website. The notify the Dr for follow-up as necessary. I always had a balancing issue between 6mg & 8mg and have been able to get it dialed in...taking 8mg on high Vitamin K days (spinach, etc) and 6mg other days.

migmog profile image
migmog

Cariologist decided to take me off Warfarin due to INR levels being so haphazard - earlier on in 2012 had a mini stroke. So 2 weeks ago changed over to Dabigatran and all seems to be going well.

moggdog profile image
moggdog in reply tomigmog

hi mig .r there side affects with dabigatran? and r u allowed 2 drink?

LZuk profile image
LZuk

I started on Pradaxa and had no problems at all. Had to switch to Warfarin due to an ablation.

poohbear1 profile image
poohbear1

I had been on aspirin but after another AF episode was advised to go back on anticoagulants. I was offered the choice of the new anticoagulants but due to to lack of reversal agents decided to stay with Warfarin. Also due to the drugs being new there is no knowledge of any long term side effects.

mumknowsbest profile image
mumknowsbestVolunteer

have been on warfarin for years with no problems. I self test and so dont have to visit hospital or have blood tests. If I had a reaction to the warfariin I might consider changing but my motto is if it isn't broke don't fix itg

watchdog profile image
watchdog in reply tomumknowsbest

how do you self test. I have to go to hospital for tests

mumknowsbest profile image
mumknowsbestVolunteer in reply towatchdog

There is a machine called coagucheck which you buy and then the tests strips you should be able to get on prescription. You need to get the hospital and gp's co operation but then it is just a case of a finger prick and the machine does the rest. you then ring the hospital or whoever with your results and they then tell you your dose of warfarin. I did this because I was unhappy with the infrequent tests at the hospital. I now test once a week or every 2 weeks if it is stable but if I am having a blip I do it more often regardless. I only ring the clinic if there are drastic changes.

in reply tomumknowsbest

I too have a machine so can self-test. Takes all the worry about Warfarin interacting with what you eat/drink/do!!! The coagucheck was expensive but worth every penny. I email my results at a frequency decided by the local clinic, but I test in between, when it suits me :)

Having been on Warfarin since May 2001 and self testing since 2005, I managed to keep my INR fairly stable....until my cardiologist switched my betablocker to Bisoprolol. I then had 15 months of unstable INR levels. As Bisoprolol was making me seriously ill, my GP switched my betablocker back to my original Sotalol and my INR levels are stable again, plus I feel like me again.

POUNDING profile image
POUNDING

I am due to start in a few days time so it is very helpful to read your comments.

TheStand profile image
TheStand

All of the new anticoagulants have not been on the market long enough to establish a good database for possible side effects. Although I do not like the side effects of Warfarin, at least it has been around long enough that there shouldn't be any surprises.

moggdog profile image
moggdog in reply toTheStand

hi stand. wot side effects have you had?

Lollipop7519 profile image
Lollipop7519

Hi,I'm getting along with warfarin no problem , but I'm struggling with simvastatin ,the doctor wants me to continue taking 40mg a day but I think I would feel better with half that or less ,

It makes me feel weary and I have dry eyes that are getting sore all the time , anyone else struggle with side affects ?

fuzzflyer profile image
fuzzflyer in reply toLollipop7519

Statins almost ruined my life, after stopping them in 2005 it took a year or more to stabilise the muscle wastage. Check Creatinine level in blood.

Feeling great ever since, along with not having cholesterol tests.

Bayer were fined billions for that damage the baycol statin did. But I understand some folks just have to take them. And some don' t get bad side effects. This Warfarin predicament is an issue I,m having problems with. As I don' t see an alternative! Yet.

Charlie0130 profile image
Charlie0130

I've been on Warfarin for almost four years and have had no problems. My visits coincide with going to class so I just drop by the office for 20 minutes and then I'm out the door. I see no reason to mess with a good thing. Plus I'm always in range unless I forget to take a tablet and that doesn't happen but very rarely.

MarkS profile image
MarkS

I manage to remain in INR range 2-3 98% of the time through self management and Vit K2 pills. According to reports this gives at least as good protection as the novel anti-coagulants. So no I wouldn't currently consider changing. It's a great comfort to know you're in range with warfarin. You do not get this with the new OACs.

Mamamarilyn profile image
Mamamarilyn in reply toMarkS

Hi MarkS I've just read your message about Vit K2 use and would love to hear more details as I really don't want to go on a chemical anti- coagulant. I was diagnosed with PAF a month ago and haven't had my follow up appointments yet. How long have you been taking it and how do you check your INR?

MarkS profile image
MarkS in reply toMamamarilyn

Hi Marilyn

I take 90mcg of Vit K2 p.d. as well as the warfarin (and have been for about 4 years). It has a similar effect to Vit K in that it buffers the warfarin. However it is the warfarin that is the anti-coagulant, the K2 simply helps me to stay in the right INR range. So if you don't want a "chemical" anti coagulant then I'm not much help. I have heard that Nattokinase can help as an anti-coagulant, though I am dubious about that.

I use a Coaguchek monitor to test my INR weekly. It's really good as my diet can vary quite a lot, but I adjust the warfarin myself to stay in range.

Mamamarilyn profile image
Mamamarilyn in reply toMarkS

Hi Mark, many thanks for your reply, I didn't understand that you took Warfarin as well, I thought that the VitK was acting as an anti-coagulant! I have to say my GP wasn't impressed when I said I didn't want to take any more meds and the feedback on the site seems to be that warfarin is not too hassley once the dose is established. I have a lot to learn about this pesky condition!!

MarkS profile image
MarkS in reply toMamamarilyn

Hi Marilyn, I dreaded warfarin when I started on it, but it has proved to be a bit of a non-event. With my monitor I keep within the 2-3 range without any hassle. Testing takes about 2 mins p.w. I eat what I want and do whatever activities I want. So warfarin can be much easier than it is commonly perceived.

Mamamarilyn profile image
Mamamarilyn in reply toMarkS

Hi Mark, many thanks for your reassuring comments!

sandrobe20012003 profile image
sandrobe20012003

I started with Paroxysmal AF in June 2006 and was put on Aspirin (don't remember dose) but it didn't work and later (July/August) that year, I was prescribed Warfarin and have been taking it ever since. My target INR is 2-2.5 and I take 3 and 4 on alternate days. It seems to work OK but I've had far less AF episodes, since being prescribed Dronedarone early in 2011. Warfarin seems to work for me and neither I or my daughter (Carer) Sian, would trust a remote machine to tell me what dose to take. Better, the devil we know ...

mumknowsbest profile image
mumknowsbestVolunteer in reply tosandrobe20012003

Hi

It is not a remote machine, the macnine is in my hot little hands and it is the same machine that the hospital use so have no problems there. I then phone the anti coagulent dept and the sister there tells me what dose to take

Hannalore profile image
Hannalore

I have taken warfarin over a period of ten years or more. Although I have very few episodes of paroxysmal AF, I take it as a precaution to prevent the risk of stroke I do not suffer any side effects My INR remains. fairly constant, so that I only have a check every six weeks. In view of this I am happy to stay with warfarin and not change to any of the newer anti-coagulant drugs

..

meadfoot profile image
meadfoot

I am on one of the new anticoagulants, Rivaoxaban, which I was prescribed as an alternative to aspirin when my CHADSVASC score increased earlier this year. So far so good, no noticeable side effects, waiting for outcome of first blood test to see if things are ok overall. I am assured that there are good medical interventions available in case of a bleed albeit not a reversal agent as such. My cardiologist, GP, AF nurse and my cousin who is an A & E Consultant have all assured me I am safe to take it. Have to trust that they are right!

Loukas profile image
Loukas in reply tomeadfoot

I'm in a similar situation having recently been prescribed Rivaoxaban instead of aspirin due to an increase in CHADVASC score. Unfortunately, this coincided with a move to Spain where I'm currently getting established in the healthcare system so have delayed starting the Rivaoxaban until I can be monitored. How often do you have your blood checked? Is it similar to the INR test?

Loukas

meadfoot profile image
meadfoot in reply toLoukas

Hi Loukas

I am taking Rivaoxaban, since Feb 13. I have been absolutely fine on it. No side effects at all. I had a blood test after a month and will have another three months after (due very soon) then only 6 monthly I am told. No issues with diet and obviously no INR checks required.

Hope you get sorted with it very soon. Good luck in Spain, what a lovely place to live.

Loukas profile image
Loukas in reply tomeadfoot

Thanks so much. Glad to hear you are problem free. Got my green health card today so just need to register with the local doctor now.

Loukas

moggdog profile image
moggdog in reply tomeadfoot

hi mead. r u allowed 2 drink with rivaroxaban?

Senyadt profile image
Senyadt

I believe that the warfarin has removed my senses of smell and taste!

fuzzflyer profile image
fuzzflyer in reply toSenyadt

Very interesting, I will keep an eye/nose /tongue on that,, thanks

skary profile image
skary

I'm on Warfarin but would change to Pradaxa or one of the newer drugs . It needs patients to try these new drugs or nothing will ever go forward into new treatments for the future. All drugs have side effects and the risk factors are still there even if you take a tried & trusted medication. Someone has to be the guinea pig .....just as those who took warfarin at the beginning of its life were.....

marytommo profile image
marytommo

DISPENSING WITH VISITS TO HOSPITAL FOR iINR BLOOD TESTS WOULD BENEFIT MY BUSY LIFESTYLE

in reply tomarytommo

Coaguchek is made by Roche, it's not cheap but Roche are very, very helpful.

Thomas45 profile image
Thomas45

Since starting warfarin in January my INR levels have been all over the place, so GP thinks Rivaroxaban would be better. He has a solid knowledge of Rivaroxaban. Warfarin also gives me itchy rashes, but they're preferable to a stroke. Hopefully Rivaroxaban won't give me any side effects.

My blood tests have been done at my local medical centre, only 200 yards away using a Coagucheck machine. Warfarin isn't an inconvenience; it just doesn't seem to work with me.

coopo profile image
coopo

I dont think going to the hospital for a INR test is a problem ,I am so grateful we have the good fortune to live in a caring society , Count your blessings these tests are free ,you have to pay for them abroad. Also if your busy lifestyle doesnt fit in with these frequent tests that could be the reason you are on warfarin in the first place. Do less not more.

I can have the INR check at my doctor's surgery so that's not a problem but with warfarin, my levels seem to be constantly up and down and even paracetamol seems to be a problem. Dronedarone sounds OK to me

Froggy profile image
Froggy

I voted yes as I would rather do without the trips to hospital / clinic for an INR test. I also have to visit hospital / clinics for other reasons on a regular basis too, some for me and others for family.

brian10 profile image
brian10

I tried warfarin but ended up in hospital with a bad bleed. As I see it They can reverse the wafarin quickly but not the others so a bleed becomes a major problem

Charlie0130 profile image
Charlie0130

No. I do very well on Warfarin. I'm consistently in range and have few to no side effects. I've never had any bleeding from it. I'd rather know that I'm in range and everything is ok. Some of these newer meds don't require a check so how do you know everything is ok. I'm staying with my Warfarin!

jopet profile image
jopet

I have been on warfarin for some 15 years with a good regular INR between 2-3. I am tested roughly every six weeks at my local Medical Centre with a few minutes wait so have no complaints. My only reason to change would be to have a drug that clashes less with all the food items which warfarin does. The answer to the question is YES I would give another drug a go for the reasons I have just stated.

dirose profile image
dirose in reply tojopet

Do you find that Warfarin, upsets your digestive system then? something is upsetting mine, am on Warfarin, so could it be this? will be grateful for your reply; or from anyone with an opinion, or with side effects, while onWarfarin. ??

Vivante profile image
Vivante in reply todirose

I have the same problem. I have been taking warfarin for many years and would gladly change the medication for something less harmful. I do not enjoy my food as much as I used to, I have recently found out I have gallstones, it may be the result of other medication I am taking, digoxin, verapamil,, thyroxin and a few weeks ago, I had the results of a dexa scan. the second one since 2006, I have osteopenia, the hips are allright, but the lumber area risk of fracture has increased.

stokenorth profile image
stokenorth

When I was taking Wararin my hair started to fall out ... I asked to be changed to Pradaxa and since then my hair has not fell out as much ... I feel much better since I started to take Pradaxa.

dirose profile image
dirose in reply tostokenorth

my hair has gone thin, and is not growing. Has anyone else had this problem? or any other for that matter?

stokenorth profile image
stokenorth

As I said I now take Pradaxa (Dabigatran) and I feel great. I used to feel tired while on Wafarin and got so fed of going each week for INR because the count was never the same two weeks together. Every time I went the dosage had to be changed, I never knew where I was with it. When on the oral ones you don't have to have a INR test at all. All GPs won't give it because it is so expensive, you might have a fight on your hands with your GP in order to get it. They say that not enough is known about it yet.

in reply tostokenorth

That is exactly what a Bulgarian cardiologist that works in the NHS., said when She advised my GP., that because I was nearly 65, she recommended that I be put on warfarin. I told her I wasn't taking warfarin and told her that there were new anti coalgulants out now. She said that nobody knew the long term side effects of the new medications. I told her I'm 65, so how long do you consider long term? It's about cost, not side effects. The good old NHS., isn't like private health insurance. With a private health insurance policy they tell you how much your premium allows you to have treatment. With the NHS., they make excuses and tell you white lies.

Dodie117 profile image
Dodie117

I would consider it but don't feel I have enough I formation at this point

Mazza23 profile image
Mazza23 in reply toDodie117

I have been on Apixaban 5mg twice a day for 20 months no side effects at all if that's any help

Vivante profile image
Vivante

I have done more research re warfarin and the link with osteoporosis. I want to be sure any future medication does not have the same risks. Check on the Irish osteoporosis society regarding the list of people who are at risk The INR levels have been good, but it doesn't help knowing that I have to be careful. I cannot bend over to get something out of the bottom cupboard, I have to come into semi squat.

Toon69 profile image
Toon69

Reversal not available

Offcut profile image
Offcut

I have been on Warfarin since 1992 and have never been offered anything else.

in reply toOffcut

Tory policy, cut backs, new anti coalgulants even though approved by NICE are more expensive, so I believe. Nobody knows what is discussed behind closed doors within the annals of NHS., fund managers offices, but if your an acoholic or junky, you can still get your booze or high paid for.

Beanz1970 profile image
Beanz1970

I've been on Warfarin before for a Pulmonary Embolism with no ill effects nod I can get checked easily at my doctors surgery so I will be opting for that again as I don't like the fact there is no antidote to the new drugs and I like to know I'm in range, kind of reassuring!

pilltaker profile image
pilltaker

i took warfarin for a couple of months and apart from the time consuming visits to surgery or hospital for blood tests

it made me feel quite ill and lethargic I asked about alternatives and was put on rivaroxaban one small pill a day and no blood tests or side effects

gerryatriq profile image
gerryatriq

normally no probs with range, but after 12 years of warfarin, am concerned about long term issues with its use.

I accept that no long term studies exist with the new drugs, but long term issues are exactly that,,,,long term. Seems to me that to change from one to the other every say 5 years would avoid any long term issues

Loquitir profile image
Loquitir

Yes. I moved to Rivaroxaban because it has higher efficacy and no monitoring requirements. No sued side effects for me.

Rellim296 profile image
Rellim296

I feel all my options are bad ones and I have no good way forward.

rumpie profile image
rumpie

No more weekly blood tests and waiting by the 'phone for results YES I would consider taking the new anti coagulant instead of warfarin. I am having an ablation at Q E Birmingham next month so hope I can eventually come off it.

Mrspat profile image
Mrspat

Have previously taken warfarin which had interactions with other medications that I was taking. This affected INR resulting in more frequent blood testing and it was hard to establish a consistent INR. I cannot tolerate the intrusion of constantly going for blood tests when I am feeling perfectly well. Also the warfarin made my hair fall out.

Christo4 profile image
Christo4

I agree the new drugs are easer no testing you can also eat what you like, I just feel safe with what I'm taking warfarin already had a mild stroke last year this was out of the blue it was a shock.these days always feeling very tired

Christo

mumsy22 profile image
mumsy22

Terrible viens from my chemo 12 years ago. No blood test with new anticoagulants.risky business anyway. Fedup. Need magic wand. On prodaxa just changed to eliquis. My stroke doctor advised risk of bleeding is lower. Cardiologist too.

cbsrbpm profile image
cbsrbpm

I have only been taking Warfarin for 2.5 weeks and my level is still just 1.1. As I have been in constant AF all this time I am a little concerned that this is not nearly reaching my target of 2.5. The new anticoagulant would make my life much easier due to the constant testing for Warfarin. I am a little concerned about there being no antidote to a bleed but then I am also concerned about a bleed whilst on Warfarin. I was not given a choice and find that explanations from the professionals are few and far between. I thank the Heavens for this site which is invaluable.

I work offshore and its not convenient to take warfarin as I cannot go for blood tests every couple of weeks.

Helpneeded877 profile image
Helpneeded877 in reply to

Are you offshore working on one of the new anticoagulant meds ?

I can't work offshore on warfarin and my doc is recommending apixoban but I don't know if I can remain working offshore on this ?

jennydog profile image
jennydog

The costs would cripple the NHS. I have no problems with warfarin

Rellim296 profile image
Rellim296

It is always worth considering any alternatives

Therealsue profile image
Therealsue

I would change from warfarin, simply to avoid the food and drink restrictions

MammaCass profile image
MammaCass

Not enough data for me to consider taking them and as yet nothing to reverse the effects should there be a bad bleed. I've not had any problems with warfarin, I eat whatever I want but don't binge, I have the occasional glass of wine too, my checks are always around 2.4 to 2.7 on 6mg daily

R1100S1 profile image
R1100S1

Concern re long term usage seems unclear and lack of reversal medication at this time.

fuzzflyer profile image
fuzzflyer

I,m unhappy to put any LONGTERM, drugs into my blood, but so far cannot find an alternative, I,m in the "don't want to live Forever!, group.

Mags1 profile image
Mags1

i would consider as my levels still fluctuating after 8 months i very rarely reach an i n r of 2

Tupelo profile image
Tupelo

Hi ,I have just come of Warfarin, and been prescribed Rivaroxaban. With Warfarin my INR was all over the place, so I was getting my blood taken every week. Which was a nuisance . So my doctor put me on Rivaroxaban . I feel good" no restrictions on my diet ,no more blood tests. So watch this space.

reedman profile image
reedman

I'm not sure because I know little about the bleeding issue. My GP certainly perceives this as a serious downside to the new drugs.

George22 profile image
George22

I don't like the restrictions on diet and other medications interactions. Plus the testing don't feel in control of my situation .

cicek profile image
cicek

I am due to see EP Specialist tomorrow and hope he will give me one of the new Anti Coags. I travel a lot but apart from that I don't want to be tied to regular hospital visits and blood tests which must cost the NHS a fortune anyway. My only concern is about reversal following a possible bleed.

monsoon17 profile image
monsoon17

I would most definitely. I have been in touch with the consultant out of clinic at Guys, requesting this. I have not heard, so I will begin to chase them.

No because my EP told me that they are too new and no antidote and I do a dangerous job. And I have no real problem getting tested and my INR is stable.

in reply to

Some antidotes for some plus there are things they can do if bleeding

Bagrat profile image
Bagrat

I am fairly stable on warfarin so probably would not be offered a NOAC at present. I'm not concerned about no antidote to bleeding , somewhat concerned about high incidence of GI upsets with NOACs but would give it a try for the convenience of not getting too worried about diet. Having said that am ten mins walk to surgery which uses Coaguchek and their software and they are happy to check prior to hols etc so don't have to search for hospitals abroad!!

mastiff22 profile image
mastiff22

I hate the restrictions Warfarin imposes on my life. I feel I have lost control.

Rellim296 profile image
Rellim296 in reply tomastiff22

I hated warfarin too and never felt safe. Switching to rivaroxaban has been life changing. My husband says how nice it is to have the usual wife back again instead of the grumpy one. If I had to pay for rivaroxaban I would do so without complaint, even if I had to take some awful job to make ends meet. It would be worth it. Life is just so much better without warfarin's hugely unwelcome impact.

ruuthmo profile image
ruuthmo

I haven't been offered an alternative but realise there are other options because of reading this site. I don't like the idea of staying on Warfarin for the rest of my life, but no other choices on offer at present. I suspect mainly due to cost of alternatives.

rothwell profile image
rothwell

Have any of you looked up 'dangers of Rivaroxoban' on the internet...horrendous!

Elected to take NOAC as INR very unstable best thing I did taking Pradaxa

I didn't voteNo, I voted yes!

shawnner profile image
shawnner

I don't want to be a "human trial" for the newer drugs. I'll wait to see how you all do first ;-) In the USA, there are constant commercials of lawyers offering "help" for people dying from the new stuff. Also, I use Roche labs testing at home 2x monthly so I don't need to go to the lab.

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