Dr Sanjay Gupta on "Best NOACS" - Atrial Fibrillati...
Dr Sanjay Gupta on "Best NOACS"
With NOAC's do you still have to have regular blood tests?
I take Pradaxa. I had to be tested for kidney function before I started to take it and the test needs to be repeated annually.
No is the answer other than a yearly Kidney test. Have been on Rivaroxaban for 18 months now with no complications other than very slight bleeding from gums to begin with.
Best regards.
You DON'T need regular blood checks to test the effectiveness of the anticoagulation (like you do for warfarin).
However with ALL the NOACs you need some regular checks on things like kidney, liver, thyroid, etc. As a minimum you need a full set of blood tests before starting any of the NOACs, then another full set after 3 months and then, AS A MINIMUM, another full set 1 year after starting and then every year after that. However note that some of the NOACs require additional tests and / or full blood tests at other intervals and for specific patients.
Look at the manufacturer's information, etc.
Very interesting, thank you.
Interesting? - yes! - I agree - but how are we to influence the choice of prescription ? or in other words - `What the doctor prescribes for us`.I found it very difficult to dissuade GP`s from using a particular drug. I was for a few years a Medical Rep. for a drug company & found that some doctors would not stop using a particular drug because they had shares in the company that manufactured it ? ? ?
Thank you for posting this - good to have such a comprehensive view of the whys and uses of each.
I have a quarterly blood test for Apixaban regarding the liver function. Terry
Brilliant thank you so much made so much sense. Currently on warfarin but fed up with the impact any change of diet has on Inr must make a decision to look into this more.
Hope this will help when I put my case for changing to NOAC. The fact that there is a 50% less chance of cerebral bleed than with warfarin is one of my reasons. I know the actual numbers of people involved are very small compared with users but if I was one of them and hadn't at least tried to get a change instigated ............. ( I know - I'd probably never know!)
Dr Sanjay Gupta deserves a medal. Think his videos are just terrific. He puts things across in a way we can all understand.
Very informative. One advantage of taking a NOAC twice daily wasn't mentioned in that the half life of each tablet is lower and therefore it is going to be quicker out of your system in emergencies.
Very interesting and useful. I am on warfarin, but not well controlled. Having to go to clinic every 2 or 3 weeks. I have asked about other Anticoagulants but have been told because I have aortic regurgitation, leaky valve none of the new ones are suitable for me. Is this correct?
I have moderate to severe leakage through my tricuspid valve. My INR is not stable and basically I have been tested weekly apart from odd ones that I have missed due to holidays.
My EP set my therapeutic range to be 2.5 to 3.5 because of the valve and because of being in persistent AF and because of swings. Hence when INR does drop it always in the last year remained above 2.0 so I am protected.
Has anyone ever said to you that you can only be on warfarin because of your valve, all the newer ones are unsuitable?
I originally was on apixaban then was swapped onto warfarin at the beginning of January last year so as to have an ablation which took place end of March last year. Initially INR was really all over the place and could SWING by 2.5 in a week. After 6 or 7 weeks still all over the place so they got me to stop all greens which helped but didn't fully rectify. It was shown up in genetic testing that I have some natural intolerance of warfarin. After my ablation INR swings reduced again even though I went back into persistent AF less than 72 hours after the ablation.
EP referred me to heart valve consultant at same heart centre for tests and assessment since although he is very willing to do a second ablation he won't do so without full agreement of heart valve consultant. Leakage is moderate to severe through tricuspid. They have done various tests (eg heart MRI, 3 echocardiograms; angiogram, bubble tests, etc). Angiogram was two weeks ago.
At present they do not want to take me off warfarin because they don't want to alter any of my medicines to ensure that the tests they are doing every 4 to 6 months are truly comparable and not influenced by different medication, because of the slight intolerance to warfarin and because hopefully I will have a second ablation. My GP had dropped my Bisoprolol from 7.5mg to 5mg be use of low BP but when I told consultant he said that they would have rather it hadn't been altered without doing tests at that point.
Dr Sanjay Gupta
Sanjay Gupta on Ablation 
