medication

Hi all,the consultant put me on pradaxa, flecainide and bisoprolol but when I went to my g p to renew my prescription he said that he could not prescribe the pradaxa, and that he would just give me the flecainide and bisoprolol ,is anyone else just on these two, and is it okay to just take these, if so why did the consultant give me the pradaxa in the first place.Thanks sophie.

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  • I am on this combination, once the consultant has prescribed a drug your GP may give you repeat scripts, however I don't believe they can initiate some drugs, but I don't think that this applies to anticoagulants as most GP s do prescribe them, I was offered them before I saw a consultant? Trouble is many gps are:-

    a. Ignorant of the importance of an anti coagulant when you have AFib because there is a higher risk of stroke, even if you have a low CHADs score.

    It took me some time to understand this as my CHADs was 0. Then a consultant said that I was risking stroke and if I did I would be in either a chair, a bed or a box, I took the tablets. One of the AFA s big campaigns has been fighting to improve GP awareness of prescribing anti coagulants to AFibbers.

    b. don't want to prescribe Dabigatran instead of warfarin because it is more expensive and any script they prescribe comes our of their budget, so costs may apply but in that case he should have offered you an alternative.

    My consultant prescribed the anti arrhythmic drug Flecainide which my GP could not prescribe as NICE guidelines say that is a drug which should only be prescribed by a consultant. Having said he did prescribe for me 3tablets when I was in the clinic and in a bad episode, I took them under his supervision to stop the episode. My GP now issues all the repeat scripts.

    I would suggest you ring the AFA and ask their advice of what to do and what to say to your GP.

    If your consultant prescribed an anticoagulant he obviously thinks it is important you have one. More or less every person on this site will take either Warfarin or one of the newer anticoagulants such as Dabigatron.

    You really shouldn't have to have this hassle to fight what you need, do hope that you get this sorted and quickly!

    For your information the AFA site has leaflets that you can download about the drugs offered and their purpose. It really does pay to be a very well informed patient when it comes to AFib to ensure you get the right treatments.

    Stay well...

  • Sophie it is good to see you back, and that you saw a consultant EP, so glad you asked the question as it is so important for your long term health, there are lots of people here that will share their experience and knowledge. Best wishes....

  • Hi Sophie

    Agree with everything that CDreamer has told you, you MUST be on an anti-coagulant, and if your consultant has prescribed it then your GP should be giving you the scrip.

    Good idea to ring the AFA patient line and discuss the next steps with them, but honestly I am disgusted that a GP is either putting money over your safety, or thinks he/she knows better than a specialist.

    Right now I'd be tempted to ring the GP and ask which it is? but then I'm feeling a little beligerent this morning.

    Be well

    Ian

  • Sophie just thought I'd mention that Pradaxa is the trade name for Dabigatron.

  • When my consultant first prescribed warfarin there was a 3 week period when my G.P.s Secretary said he couldn't initiate warfarin it was the hospital that had to do it. O.k. but then I didn't hear from the hospital either.In the end I more or less camped out at the surgery until they made me an appointment at the warfarin clinic at the hospital . After that it was all plain sailing. I often wonder what will happen when I'm old and frail and unable to stand up for my rights. ( My husband says that's never gonna happen !)

  • Hi Sophie, I agree with C Dreamer. Pradaxa is an expensive new drug and many GPs will not prescribe it for that reason. Did you ask your GP why he wouldn't? Once a consultant has prescribed a drug GPs can repeat that prescription even when it is a drug which requires consultant level agreement.

    You must challenge this and ask why if he did not want to prescribe pradaxa he did not offer you warfarin as it is vital with patients who have AF to,properly asses their stroke risk and where appropriate to provide anticoagulation. You will I expect have seen many cases on here where stroke risk has been discussed as it is the main risk for patients with AF. . Your cardiologist obviously assessed you as at risk so you need anticoagulation and please don't be fobbed off with aspirin as this is about as useful as a chocolate fire-guard in preventing strokes with AF Don't risk ending up sitting in a chair drooling due to this GP's ignorance or whatever.

    Bob

  • Now that the PPI issue is on the wane, I think there must be an opportunity for legal firms to start taking no win no fee negligence claims against medical practitioners who think it's ok to ignore anti-coagulation for AF patients. A few eye-watering compensation payouts for subsequent TIAs might begin to take care of the 'awareness' issue somewhat more effectively than the current AFA campaign. And Sophie, I would ring your doctor's surgery first thing tomorrow morning and tell them you are terrified because you now realise that, in contravention of the wishes of your consultant cardiologist, your GP has left you entirely unprotected from stroke. Lay it on thick and they'll reverse their foolish decision in a heartbeat, so to speak.

  • thanks guys for all your advise, will try to get it sorted tomorrow, sophie

  • From what I read on this forum - I can't believe the attitude of some GPs. Very worrying. Unless they are simply feeling liverish, then it can only be they are in the wrong job and should take up something less demanding.

    David.

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