Long term Warfarin

[bluebell111]

Hi, anyone have views on taking Warfarin long term....I have been on it for 5 years......does anyone know if there are any alternatives. thanks

[Hidden]

There are several alternatives. Warfarin is the first line of defence as it's cheap. The new, or 'novel' anticoagulants are available and don't need co start testing. INR should stay in target (normally 2-3), for warfarin to protect against stroke, and not go too high to make a bleed possible. I take warfarin, have done for 4 years, but thousands have been on it MUCH longer. I home test and the medical centre provide the test strips. I'm ok on it, but wonder if I could feel better on Apixiban or similar.

[Hidden]

Yes there are, they are called NOAC's (I think the new term is now DOAC's) and there are a number of alternatives so I suggest you either google or use the search box on the top right to find out more. They all work in a different way to Warfarin and do not require regular INR testing which is a great advantage. There may be some resistance from your GP as they are more expensive than Wafarin, but assuming your liver and kidney functions are OK, you have the right to take them if you wish....I'm sure many others will add their comments too....good luck......

[Finvola]

There are four other anti-coagulants - Apixaban, Dabigatran, Edoxaban and Rivaroxaban, the so-called NOAC's. If you go to the main AFA website, there are leaflets on each of them in the patient information section. I have taken Apixaban for over three years without problems.

[Hidden]

You can read information on your anticoagulant options in our booklet which can be downloaded from heartrhythmalliance.org/fil... Or if you prefer a paper copy, please email [e-mail] with your details, and I will send one in the post.

Best wishes, Rachel - AF Association, Patient Services Associate

[BobD Volunteer]

I have been on warfarin for twelve years with zero problems but for some unfortunate people it can be a difficult road to follow and for them NOACs are a boon.

[bluebell111 in reply to BobD]

Thanks Bob, you are always such a calming voice in the storm, just worried about the recent reports about dementia as my memory does seem to be getting a lot worse & my husband has had a couple of spells where he in the middle of something very routinely done, forgets what he is doing, do you think being on NOACs would be any better.

[seasider18 in reply to bluebell111]

Your GP can give you a memory test appointment that seems to basically be for short term memory. In 2015 they were offering it on the days they were doing flu jabs at our surgery.

[ILowe]

I know people who have been on Warfarin for over 30 years, with no problems at all in daily life. Why are you on Warfarin? For most people the NOACs work, but in some cases, such as heart valve replacement, Warfarin has some extra ways of protection therefore is obligatory.

Just tell everyone you are on warfarin. Check and double check interactions with other medicines, and usually the pharmacists are the best people to advise you: they are the experts and if you catch them when they are not busy, no appointment needed! My experience is they will also communicate fearlessly with the doctors if there is something questionable.

[Hidden]

youtube.com/watch?v=GFPGZF2...(Not working as expected?)

youtube.com/watch?v=odECUAj...(Not working as expected?)

[Gmc54 in reply to Hidden]

Thanks for posting this, I am considering asking my GP if I can come off warfarin, and this gives me so much information in a comprehensive way.

[Dap19]

I am on Apixaban by choice. After my stroke 16 months ago I was told I would have to be on Warfarin. I started asking all the young doctors their views and they both suggested apixaban. One of the doctors father was taking it.

[MarkS]

The key issue with warfarin is to remain in range. I use a Coaguchek monitor to help me do this, and I would recommend anyone on long term warfarin to get one. Having to test warfarin is both a weakness and a strength. Personally I find testing a minor issue - 2 minutes a week. The strength is that warfarin is the only anti-coagulant whose effect can be measured. NOACs have a broader range than warfarin but serum levels can still vary by up to 5 times.

The long term effects are much better known with warfarin and are generally very benign. I would suggest maintaining vitamin K intake as it helps prevent osteoporosis and atherosclerosis. I take Vit K2 for that.

[bluebell111 in reply to MarkS]

Thank you have just started looking at taking vit k & K2 & have just ordered a Coagu check. Good luck Mark

[MahendraW9]

I took warfarin for about 9 years, but I monitored myself with an INR testing kit I used at home. Also, I used dried kale powder I prepared during the summer months to ensure that I get a consistent dose of Vitamin K to balance the warfarin throughout the year. I was able to keep the INR within target, by varying the kale intake. However, about 3 months ago I switched to Apixaban, which requires no testing. So far I am ok. Best of luck with your treatments.

[bluebell111 in reply to MahendraW9]

Thank you that is the sort of help I need....have ordered a coagu check & will look into vit k......was it your choice to switch to Apixaban & the reason? Hope all goes well for you.

[MahendraW9]

The reasons for changing to Apixaban were: convenience; no more INR testing on a weekly basis at home; got a bit tired of eating kale everyday to ensure I got enough vitamin k to balance the warfarin; my Doctor's advise. The advantage was that I could travel anywhere as long as I had my dried kale and my INR testing kit with me. As you know most hotels/restaurants don't serve enough greens to keep the warfarin blood thinning within limits. Apixaban is convenient, but one drawback I faced recently is that during a bad flu, I blew my nose too much and I had a nose bleed. I pinched the nose for about 10 minutes and was able to bring it under control, but with warfarin, I never had any such bleeding problems. My doctor advised me to go off the Apixaban for a day, which also helped heal the nose bleed. If you are going to get an INR testing machine, please also make sure that at least once a month you submit a blood sample to a testing lab so you can compare your home test results with the lab results (this way you know your home test machine is fairly accurate or within close range to the lab result). Take care!

[bluebell111 in reply to MahendraW9]

That is the sort of information I have looking for particularly I wondered about the Apixaban & making sure the coagu check is calibrated. ....Thank you