The pros and cons of Warfarin v Rivofloxabin and is Rico ..suit if you had heart surgery ..valve replaced ?

[overmars]

As above .please community ..help ! I see Dr Gaffer in end Dec for a chat on this

[BobD Volunteer]

Sorry I am not qualified to answer that question.

[overmars in reply to BobD]

Fair dinkum ! Let the Doc worry instead !!!

[SRMGrandma Volunteer]

Here in the US, rivoroxaban as well as dabigatran and other novel anticoagulants are not approved for use in patients with artificial heart valves. Studies that were conducted were ended prematurely because of increased bleeding in those taking the NOAC's and warfarin is the drug of choice in that circumstance.

[seasider18 in reply to SRMGrandma]

Do you have a mechanical or a tissue valve? They will not prescribe NOACS if you have a mechanical valve. The manufacturers also say no for tissue valves but here in the UK cardiologists will prescribe NOACS saying that it is just that they have not been tested on tissue valve patients. I go with the makers and refuse them having asked each maker the question.

[overmars in reply to seasider18]

I see Doc early Jan .

We shall see .Boots Pharmacist said Rivo ....is better than Warfarin and safe too ..doc hints there are drawbacks ..doc has final say ..going to blood clinic is not pleasant as issues there .. A Peggy Mount in charge

[ILowe]

Warfarin is well known. It has been standard for heart valve replacements for decades. Even the long term use is well known. It is also cheap. People in A and E know it well and can give a speedy antidote.

The initial dosing, and stablilisation can be tricky, but well known.

Takes a year or so for the body to adapt to it in terms of minor bruising etc.

Do not get trapped into trying to achieve a narrow dose range and most dosing problems solve themselves. Explanation. If they set your range as 2.5 to 3.5 then some people will find it hard to stay in range. But if you accept 2.5 to 4.5 then you will find that dose changes are rarely needed. I have sometimes gone from say 2.3 to 4.3 then 2.6 etc, all without changing the dose. Setting a wider acceptable range is very important for stability. But that is another discussion -- methods of self dosing.

So, accept Warfarin, learn to live with it. Let others be those experimented on.

[overmars in reply to ILowe]

Good advice mate . I see Doc in jan for a chat

[seasider18]

From the European heart journal.

eurheartj.oxfordjournals.or...

[Mrspat]

I had a tissue aortic valve (bovine) put in over 3 years ago to correct a congenital defect. I had pre and post operation PAF. I am 62.

Pre operation I was on aspirin for about 7 years, during which time I had PAF. Post-operation I was put on Warfarin, being told this was a temporary measure. I was aware that tissue valves do not normally require permanent anti-coagulation although mechanical valves do.

After about 6 months I persuaded my GP to change me back to aspirin. The cardiologist insisted on anticoagulation. She was prepared to prescribe Ribaroxaban and my GP agreed.

I loathed Warfarin and would have found myself with a dilemma had I been refused an NOAC for whatever reason. I can bore for England on the subject and have done so on this Forum many times.

I'm not qualified to comment on anyone else's condition. However, the relevant factors in my particular case seem to have been that the new valve was tissue and not mechanical and that it was an aortic valve not a mitral valve. The cardiologist said that her reason for wanting me on an anticoagulant was because one of the chambers of my heart is slightly enlarged, which is an additional risk factor for stroke.