Warfarin

Can I please ask what is the thinking now regarding the alternatives to Warfarin. I am aware that the other meds are expensive so warfarin is still the first port of call. I have been on warfarin for two years had one period of eight weeks where it was fairly stable but apart from that it is hard to keep in range. If my diet changes at all it becomes very unstable. Or take paracetamol it changes.The reason I didn't push for new meds was because there wasn't an antidote and warfarin is tried and tested. However with my retirement in sight next year and plans to travel I think I might bite the bullet and ask for new meds. What's the concensus please. My af has been great odd ectopic and certainly tiredness a blessing of bisoprolol fleck and being 62 I guess. So one day at a time and accepting this is all part of trying to manage af. Many thanks to you all for great support over the last 3 years. Happy symptom free new year. Regards chris

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  • My INR was very stable until I went on a no-added-sugar diet to prepare for my ablation. It shot down from 2.5 to 1.4 and refused to budge. I had my ablation at 1.8. Afterwards the EP prescribed dabigatran (Pradaxa) due to my "unstable INR." There is now an antidote for it called Praxbind.

    I do wonder if the antidote thing is a bit of a red herring. If you are in trouble they are not going to let you bleed to death and in any case, what is the chance of Praxbind being available in some far away foreign location?

    Pradaxa is 1 tablet per 12 hours. It's easy but get your liver and kidney functions tested before you start and then annually.

  • And tested three and six months after starting.

  • I knew that they tested me before I started Pradaxa but nothing else was said. In September I asked for an annual check as I had been taking it for 13 months. I find it very worrying that the monitoring is so poor.

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  • I used to be very against these new drugs but since changed my view. If you are OK on warfarin and have , like me, a stable INR then fine but for the others then NOACs are a boon. The antidote thing is a red herring to be honest as there are ways of dealing with any major bleed and in any case the half life of the drugs is very short.

    In UK you have the right to be on what you want not accept what the doctor prescribes so read up the fact sheets on AF Association website and discuss with your GP.

  • Thank you Bob

  • i've been very pleased with Apixaban- best to read up about them all so you make good decision!

  • I was concerned about the lack of antidote and about the expense of a NOAC, but my GP swept these concerns away. Many drugs are more expensive than the NOACs, and in terms of stress and annoyance, I found Warfarin very expensive indeed. It robbed me of my sense of wellbeing. I am overwhelmingly happy on Rivaroxaban and many times every day I remind myself how fortunate I am to have my life back again.

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  • was put on a NOAC from day one was happy with that so did not argue, theory was that it was stable and aby extra costs was covered by not having INR tests.

  • Thank you for your support.

  • apixaban no side affects for me, set my phone to take it, job done

  • I've been on warfarin for 2years with no probe. So I was happy with it.

    Recently I went out of range.Don't know why, eating habits the same.

    However I was put on 2 week checks meaning I had to take days off work

    I was also planning a trip with grandkids to Disney in Fluoride in February.

    Guess what, because my inr is now being checked more frequently than every four weeks my travel insurance won't cover me.

    I have permanent asymptomatic AF and feel fine.

    Went to my Doctors. Yesterday and told he wasn't in, "would I see someone else?" I did see another Doctor, told him my probe and he said "you want to get on one of the new anticoagulants" Told him I was well researched on the subject and he said"which one do you want". I picked apixaban.

    Now sitting at home with apixaban in cupboard waiting for blood test and change over.

    If you work or travel then you never know when warfarin will throw a wobbly No obtained to me. Get on a new one and that's once less thing to worry about.

    Good luck.

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  • My husband has been on Apixaban for over a year an likes it much better than warfarin. The NOACs are working well here in the USA for those who do not have bleeding issues or weak hearts - aside from Afib. My husband has only Afib and atrial flutter.

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  • I was on riveroxaban found it fine 😀

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