Apixaban

Could someone please tell me which is the better for you warfarin or apixaban

My levels on warfarin have nearly always been wrong

Have been on them for at least 8 years heart doc has agreed to apixaban renal doctor has agreed pharmasty has agreed but gp not agreeing to it

I have to say I'm scared of change due to kidney transplant has anyone out there have any views on this thank you I also think it could be due to cost

Mixed up am I ha ha

14 Replies

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  • Its weighing up risks and benefits. If your warfarin control is poor then that is a reason for the apixaban. It can adversely affect your kidneys though, but if your renal doctor is happy with it then the decision is pretty much made. Although more expensive, there seems good reason for you to be on it.

    Perhaps discuss with another GP, get a letter form your renal doctor.

  • I don't think we can answer this for you as it depends on what sounds like a complicated medical history.

    Your GP may be worried that your kidney function is not reliable enough for the drug to be excreted fully - therefore builds up and is too effective,

    The GP may be the one who prescribes this for you so has to take the decision/ final responsibility ??

    NICE has said patients can choose, subject to clinical issues- which you may have - but it means it's unlikely that cost is coming into it- ( this was the case until recently)

    Just seen Goldfish's reply below and agree you need to talk to all concerned again

  • Thank you yes it is a complicated medical history also pmr although not sure about this

    Also spinal problems which don't help with medication

    Had these problems for years learnt to accept them but at the age of 71 and a couple of falls finding it a bit difficult at times to accepts these things

    Never mind we can put it down to a bad few days and the loss of my husband 2years ago not helping but I will get there lol June

  • If your INR is unstable on warfarin then one of the NOACs makes sense provided that it does not affect other health issues. I suspect that since your medical team with the exception of your GP are in agreement then this is a local cost issue. NICE guidelines are such that NOACs should be encouraged for those with unstable INR so suggest that you go back and discuss again as has been suggested.

  • just wondering about the kidney transplant aspect Bob....it may add a different dimension.....I think Goldfish has a good point though, if the Renal Doc supports using Apixaban.....push for it

  • That is why I mentioned that the medical team seemed to agree.

  • I've been in warfarin for 4 years. I bought my own home test machine from Roche and my medical centre supplies the test strips. Works well for me.

  • Does this machine stop you going to the doc. Unless there is a problem and are you in the uk

    Thanks June

  • Yes, I never go to the INR clinic, once in a while I phone my result through. I self medicate. When you're used to it it's easy.

    Once a year I take my machine to the clinic just to calibrate it against theirs and it's always fine

  • As your Consultant team agree your change to Apixaban,go for it! Your GP should have had lettters from the hospital confirming your change to Apixaban,so it is down to price that he is reluctant!

    Good luck!

  • I was told at Stafford hospital that Warfarin has been used for over 50 years so well understood and there is an antidote if you take to much which is VitAmin A. Which they don't have with other medications. The only minus is you have to have regular blood tests to keep check on your INR level. I have been stable on it for 3 years and have a friend who has been on it for over 20 years.

  • When I was on warfarin twice INR rocketed up and I was given both times vitamin K once drops on tongue in England and vitamin K drop in Kefalonia

  • I'm sure there were posts on here suggesting that if you took vitamin K regularly (ie a small dose every day) then your vitamin K levels would not oscillate so wildly with what you eat, and consequently it will be much easier to stay in range with warfarin. This might be the way to go . . .

    Try putting Vitamin K into the search box top left - and see what you can find . . .

  • Since my diagnosis of AFib in December 2015 I have taken warfarin. On this site I saw a post from @MarkS which outlined the benefits of vitamin K2 MK7 (to be precise, as there is a difference) which seemed logical to me and I started taking taking it daily. My INR levels stabilised between 2-3 and I don't even think about what I eat. As a safeguard I also bought a Coaguchek device. My personal experience is that the biggest cause of any wild swings in my INR is totally related to illness. I had pneumonia this January where my INR went over 6, and then before I had fully recovered caught a cold which brought my INR back up to over 5.

    So for ME (stressing that!) when I am unwell I check my INR and if it is high, bring forward my appointment with the INR clinic in the surgery and my dose is adjusted.

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