Are the new anticoagulants better than warfarin does anyone know

[barnes12]

[Beancounter Volunteer]

Define better?

They both anti-coagulate, which of course is what they are meant to do.

Some studies say that the risk of bleed is smaller with the NOACs but all the ones I have seen it's quite marginal.

NOACs do not yet have an antidote although they are under testing.

Does this help?

Ian

[barnes12]

Im not sure what I mean to be honest Ian guess I mean are they safer re bleeding they say you dont need testing so much

[Rellim296]

I have the feeling that the new drugs may be proving to be slightly better at reducing strokes and they have the advantage of giving you a level of protection that does not waver. Warfarin can be fairly stable for some people and less so for others. One can easily drop out of range and have less protection or go over the top and be at risk of being prone to bleeding excessively. The down sides are that the new drugs do not, at present, have an antidote - whereas warfarin does - and the long term side effects are not known.

If you need a surgical procedure, it is likely that you must swap to warfarin and be in range for a month beforehand.

I wondered if health insurance companies favoured warfarin, but when I enquired, it did not seem to make a difference.

The new drugs are much more expensive. However, they offer (to my mind) better quality of life as they do not seem to interact with food and there are no dietary restrictions. I am not sure if they interact with other medications and herbal remedies.

I find I am talking myself into favouring apixaban again, but as I wrote to my GP and refused to take warfarin on the grounds that I was scared of being anticoagulated because I have had a few cuts and fractures, how can I now turn round and say I'm sure I'd be fine? I am even more scared of the new drugs! I have had a few horrid painful little spontaneous bruises on my fingers while on warfarin and it worries me a bit if they also occur elsewhere on the inside. I really dislike taking warfarin and it gives me hardly any sense of security, but by taking it I am not open to criticism if something goes wrong. I just hope it's not the sort of nasty cut I had a couple of years ago, which was a real drip .. drip ..dripper and I had to make a man lend me his mobile phone so that I could ring my husband to come and get me as I had planned to walk home across several fields and thought it imprudent. I ended up in A & E and came home in plaster as I'd also broken a bone in my hand.

I don't go out walking on my own any more after a fractured pelvis episode. Just glad I had my phone with me on that occasion and had a signal.

[Barb1]

After being on Warfarin for 3 years, I am now on Dabigatran as my GP was unhappy with me self testing when away. I am not too worried about there being no antidote as there are ways of replacing lost fluid whilst the coagulation kicks in. Whilst on Warfarin, I was hospitalised for 2 haematomas and a nose bleed. Vit K was not used, they just waited for 4 days, so I reckon with the new drug I would actually have been out earlier. So far, the only side effects I have had are stomach cramps with diarrhoea but not too often. The nose bleeds and bruising have diminished and I don't have to worry about eating and drinking!

[Rellim296 in reply to Barb1]

Thanks for that - reassuring. My other half is good at first aid and is encouraging me to be adventurous, but my children (and one has a partner who is an anaesthetist) are more conservative and favour warfarin.

Do we know about interaction between the new anticoagulants and other meds, or it this something that only the fullness of time will reveal?

[Hidden]

I've been on apixaban for over a year now and touch wood am ok and I only need a blood test once a year the only draw back if you could call it that is you need to take 1 tablet twice a day so I take 1 at 9am and 1 at 9pm.

[Rellim296 in reply to Hidden]

Thanks, Linda. It take flecainide twice a day so that wouldn't be difficult, though now I think about it, I might actually manage to give up flecainide. I'm down to 50mg (from 150) twice a day post ablation. Anyway, I'm used to two a day.

[Hidden]

I'm on Rivaroxyban and take 1 x 20mg tablet each day. I also take several other drugs for BP and Diabetes with no problems. The anticoagulant effect is one day and operations are straightforward because of this. There is no antidote however much can be done to counter the anticoagulant effect for the time remaining of its 24 hour effect. Rivaroxaban is not affected by diet or drink. It is also had less cranial bleeds than warfarin. All in all a superior drug based on FACTS.

[mumknowsbest Volunteer]

Have been on warfarin for 10 or more years and never had any problems and I now self test. My motto is if it ain't broke don't fix it, especially as I seem to react to quite a lo of meds, so

I 'll stick to what I know. Just me though

Eileen

[Buffafly]

So far better for me. When I was on Warfarin my INR would not stabilise, I had bruising, bleeding and other side effects and needed testing every week. Aspirin which is useless anyway but what my doc told me to take was the same with bad stomach pains and nausea to add to it. So far on Riveroxaban have had no bad effects I could blame on it and it does not seem to interact with anything. Of course only time will tell if there are any long term effects.

[mkp589cmn]

I am on Pradaxa and would not be on anything else. It not only is a blood thinner but also a stroke preventer. I had a seizure due to AFib not letting enough blood go into the brain. The AFib was making the blood pool in my heart. It was not until I had the seizure that I was diagnosed with AFib officially. Even tho I had complained for 10 years about rapid heart beats, fatigue, weight gain, etc. I was in the emergency room after the seizure and my heart rate went up to 202. The Dr's got moving then. Went for all kinds of tests and have a great neurologist and cardiologist. Seizures are controlled with Keppra and they tried to control the AFib with meds. The AFib was not able to be controlled with just meds. So I had a cryo ablation. It was a success even tho I have flutters every now and then. I am now on metoprolol and Propafonone along with Pradaxa and Keppra. So the Pradaxa is helpful for both AFib in that it thins the blood, and it is a stroke preventer if I ever have another seizure. But, my point in telling you all of this is do not do what I did and just say ok and walk out the door. Be persistent, make them do tests until they find something, and call them every time you think something is not right. I hope my story helps you. I think Pradaxa is the way to go since it is multi-purpose. Good luck.