Warfarin v Apixaban

6 years after ablation I've spent the afternoon at A&E following a couple of days of fast AF. Unfortunately flecanide didn't work this time as it has on previous occasions.

I now need to decide whether to take warfarin or Apixaban ahead of another cardioversion, and maybe ablation further down track. I know warfarin's stood the test of time but I'm tempted by a NOAC this time. Mainly because I don't fancy those weekly visits to the local clinic and never being sure whether I'm going to be in range or not.

Anyone else been in this position, and how did it work for you?

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40 Replies

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  • I was put onto Apixaban after my mitral valve surgery and had no side effects. It was fine.

  • Hi Suzie, how did your mitral valve surgery go. I was told that I might need one and I am pretty nervous about it

  • The surgery went well. I had it at Liverpool Heart and Chest Hospital. It was minimally invasive which saved opening up my whole chest and meant recovery was much quicker. I was out of hospital after a week. The surgeon was fantastic. I'd be very happy to recommend him if it looks like you're going to need the surgery. Keep me posted. I know what you're going through now. It seems scary, but it really is fine. 😊

  • Thank you so much for your very comforting reply.

  • Let me know how you go on. 😊

  • I sure will. Thank you.

  • I've been on Apixaban since it first came out with no side effects. Was previously on Warfarin and like you always had trouble with INR readings etc. I vote for Apixaban anytime!

  • That is true for me also. Switching from Warfarin to Apixaban was like coming out from the dark into the light. No regrets whatsoever.

  • Hello have just started Apixaban, and really worried about all the side effects I have been reading about, I want to takevitamin K2 to clear my arteries out from Wafarin.

    Best wishes

  • My vote would be Apixaban, but then I never went for Wafarin period.

  • I couldn't be stabilised on warfarin what really convince me was being in hospital on a Greek island due to Inr of 9 I take pradaxa without any problems

  • Top of the leader board, hassle-free apixaban.....every time.

  • Apixaban - I assume from your message that this is just as prep for the cardioversion and ablation right? Or are you now permanently indicated for anticoagulation?

  • Thanks. Hopefully it's just prep for cardioversion and/or ablation!

  • I came off Warfarin and onto Apixaban because my INR would occasionally go out of range, also to stop having blood tests, but mainly because I was told that the risk of a cranial bleed was less on Apixaban. Koll

  • I changed to Apixaban from warfarin. Best thing I ever did. No testing or diet restrictions and for me no side effects. Patricia.

  • Thanks to all of you for your responses. There seems to be a clear "winner". My only slight concern, as mentioned by the doc in A&E, is that Apaxi is still fairly new and longer long term issues haven't had a chance to surface yet, but I'm low risk so happy to give it a go.

    For me this is one of the real assets of this site- the ability to share experiences like this and help each other.

  • Apixiban is designed specifically for AF.

    I've been on it like I said with no side effects. I believe BMS has been working on a way of an 'antidote' to stop bleeding in an emergency. I have not heard if they've had any success!

  • Apixaban has a half life of 12 hours which means if you stop taking it it will be out of your system quickly. So it is not too much a problem having no antidote yet. If there was a real emergency they could give you a blood transfusion.

  • My EP Cardiologist said he would choose Apixaban for himself and added that he would also suggest it for his mother. No further questions or needed!

  • I'll be the appropriate percentage and say I had a bad bleed made much worse as the apixaban had built up in my system (kidney problems) and as there was no antidote it was only stopped by blood transfusion.

    I completely accept I was unlucky and the apixaban was only one factor in the equation but make a decision based on your appetite for risk compared to the advantages.

  • I've just moved from Warfarin to the newer noac, Edoxaban. It's supposed to be as effective as Apixaban and 'designed' for AF with a low bleed risk. Advantage over Apixaban is it's just once a day. So far no issues with it.

  • I take Warfarin but only get tested every 8 weeks which I can cope with, my Sister swapped over to apixaban after 8 years on Warfarin as her Dr said Warfarin wasn't working & her veins were awful, she has had no problems with apixaban & doesn't have to watch what she is eating

  • I would not be comfortable having INR tested only once every eight weeks.

  • My INR has always been 2.2 or 2.3, I try to eat a similar diet & follow dietary guidelines that obviously helps me

  • My cardiologist told me that it would be ok to take Apixaban but if i needed to have another ablation in the future his choice pre ablation would be Warfarin. Hope this is helpful.

  • I would quite like to try one of the newer drugs but I've been told that I can't because I have an artificial Mitral valve, but it seems there are others of you who have artificial values and take the newer drugs so I am very confused 😕

  • Apixaban no brainier felt 10 years older on warfarin and i believe my father got dementia through taking warfarin for 36 years it made his vains weak in his head and bleed he had loads of TIA before he passed away thank god for apixaban

  • I tried 2 of the newer drugs But had side effects,,,,,also felt more comfortable taking something that already has a reversal agent,,,hence,I am on warfarin 8 mos now with no issues at all,,,,I live in the USA and there is a company that rents home testing monitors,,,my monthly cost is $2 after insurance kicks in,,,I only have to prick my finger once every 2 weeks and have always been in range because my diet is very stable,,,always eat the same kind of foods,,,,just watching the very dark greens,,,,,it really is all about choice and what you feel works for you,,,,you can always change if one does not work for you wherever you start,,,,,good luck!

  • Good point, thanks for your input.

  • Apixaban is easier. But I have only had that so others might prefer Warfarin.

  • I have been on warfarin for two years now and have had no problems, I only have to get my inr done every twelve weeks and I am always in range but I also eat very much the same meals week in week out , I have had one GP saying stick with warfarin and another GP wanting me to try one of the new drugs , I made the decision to stick with warfarin as it works for me and also my Late father in law took a massive stroke within a matter of weeks after changing from warfarin to one of the new alternatives.

  • It depends whether you can get warfarin to work ok for you. If you can stay in INR range most of the time then warfarin is just as good as apixaban if not better. The advantage of warfarin is that it can be tested and proven to work, with apixaban you just hope it does and the dose is right. Personally I don't find testing with my coaguchek once a week a problem. I also eat what I want and my diet is very varied.

    If you don't get on with warfarin then apixaban is a good alternative.

  • Cheers Mark, I'll bear that in mind.

  • I was given all the info and Nice guidelines by my GP re:- anticoagulant and left to make my own mind up. I chose tried and tested warfarin. It frightened me the fact that there is no antidote to the NOACS in the event of a bleed, plus we don't know long term side effects. I can't get my head around the fact that they don't check your INR on NOACS, seems like pot luck !

  • Fair points, and the reasons why I didn't go for Apixiban straight away. Thanks.

  • Never regretted going onto apaxiban, no problems whatever

  • I had terrible side effects on apixaban, rivaoxaban and dabigitran.

    Thankfully my doctor let me have the new kid on the block edoxaban.

    I do get a lot of flatulence on this one, but really didn't want to go down the warfarin path for all the reasons you mentioned

  • Thank Mikee, guess you don't really know about side effects until you start to take something.

    Hope your little problem soon blows over!

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