Discussing NOAC/Warfarin question.

[Dadog]

I had an interesting session with my INR nurse, who, in conjunction with one of the GPs in our practice, who runs all things to do with AF. I asked her opinion on the pros and cons of switching to a NOAC and was given a very full run down. I mentioned the extra cost over Warfarin and was told it made no difference - taking in consideration her time, administration, etc. I came away with 7 sheets of printed matter on Rivaroxaban which is what they would prescribe and invited to a discussion with the GP when I wanted to go further.

When it sometimes is like wading through three feet of mud to find some facts or progress with the treatment of our condition, it was so refreshing to receive such help and advice.

Now...I have to decide. Pros and cons each way. We shall see!

[Finvola]

It's good to have a sensible, clued-in practice Dadog.

[Dadog in reply to Finvola]

Certainly is, Finvola. I have sympathy for those who don't. Life can be hard enough with AF.

[Hidden]

Dadog, I must admit I'm beginning to wonder what the pros are with warfarin , even though I self test. It will be interesting to know what you decide on and why.

Sandra

[Dadog in reply to Hidden]

Well, Sandra, at first glance the obvious pros are the lack od need to have regular tests - I was told a six monthly test was required. Then no more diet watching - eat what you desire! My first read through of the side effects seemed pretty well the same as those for Warfarin. Not all NOACs have an antidote, should it be required. (reading on here, most seem to).

Important to take a NOAC regularly and not miss one as you go straight back to an unprotected start apparently - but the effects return after the next one taken. I'm still learning and checking what will suit me best, so will be watching this forum with interest!

David

[Gertsen in reply to Dadog]

My GP is pretty clued up and told me the effect of apixaban lasted for about 12 hours if you forgot to take one. I asked about thanking them when travelling, and she said better to take one a bit later that too early😊

[Hidden]

And I wonder what the pros and cons are of the different NOAC's. My EP went straight for Apixaban in my case. I didn't ask him for a comparison, he just said it would have a lower risk of brain bleed. Maybe he was referring specifically to Apixaban or just generally to NOACs?

My GP said the same re cost, weighing everything up it didn't make any difference.

Koll

[jennydog in reply to Hidden]

My EP went straight to Pradaxa (dabigatran). This seemed to be the one that Dr Gupta preferred on his video. It is great not to have to traips to the warfarin clinic and worry about your INR. There is also an antidote called Praxbind.

To my eternal shame I started on Pradaxa and ate a whole packet of dried cranberries that had been languishing in my store cupboard for ages.

[Dadog in reply to jennydog]

I bet that was nice jennydog! Cranberries, blueberries, spinach....love 'em all! I'm not a drinker but to indulge a little after a good meal would be nice!

[seasider18 in reply to Dadog]

No reason why you shouldn't as you say indulge a little.

I have broccoli and other greens every day and a large glass of Red wine. Perhaps though it is why I am on 8mg of warfarin to keep within my range . Actually it is strange how we respond differently to warfarin. One neighbour who enjoys a glass of wine gets by on 3mg a day and one with two visits a day to the pub takes 6mg.

[Dadog in reply to Hidden]

They all seem to have their favourites, Koll. Anyone's guess as to why....cost, supply, assessment of performance?

The cost effect is interesting. I said to my nurse that I didn't want to put nice people like her out of a job and she just laughed........nervously!

David

[seasider18 in reply to Dadog]

The nurses at my practice hate their boring repetitive Warfarin testing days as they have well over a 100 people a week coming for them plus homebound self testers phoning in at supposedly pre arranged times. They would much rather be doing other things.

[Hidden]

We are glad that your nurse has been helpful Dadog. There is a comprehensive article on NOACs in the AF Association newsletter. You can read it on our website at atrialfibrillation.org.uk/f...

[Dadog]

Thanks Rachel. I shall read everything and continue a proactive approach on this.

[AnticoagulateNow]

Cons for NOACs? What cons?

[ILowe in reply to AnticoagulateNow]

For those with AF only, the Cons for NOACs are harder and harder to find. But for those who also live with artificial heart valves, I read somewhere that Warfarin protects in more than one way, and these extra ways are important.

[Annekw]

I've only been on Apixaban,and as a retired SRN I was delighted not to have to take Warfarin!

Apixaban appears to be the favourite in my area.

[byoungccs]

A very enlightened Nurse who is quite right regarding equivalent cost of Warfarin v NOACs

With NOAC evidence supports safety & consistent effectiveness v Warfarin so long as you take it each day. Also less food restrictions and drug interactions

[Hawkie147]

Re: Warfarin versus NOAC.

I am in a right dilemma as to push for a change from warfarin to one of the new NOAC or stay as I am

I did broach the subject yet again with my GP and she definitely was far from enthusiastic.

I wonder if the fact that I have been on Warfarin for 15 years and also has my age got any bearing on the subject. I am 77.

What do you nice people think.

Lol Jean

[Dadog]

Some GPs will be enthusiastic - and some not so, Hawkie. Don't know why. I'm 79 and been on Warfarin only 3 years but as you see, GP and nurse both happy for me to change, Specifically, they said to trial the NOAC and if it didn't suit, go back to Warfarin.