Warfarin or apixiban?

[cali111]

I was taking Apixiban for over a year but was changed to warfarin due to a clot being found pre-ablation. The EP said that warfarin is a more aggressive therapy, but I have since found out that the thoughts of researchers say that apixiban gives a better protection than warfarin. What are the thoughts of the community as I want to change back?

[BobD Volunteer]

Complex subject. I think the crux is that warfarin is the gold standard if the patient is always in INR range. That being the stumbling block. I'm lucky I think in that over the last few years I have been in range over 85% of the time (at least at testing times) but that doesn't say I always am. I could be well down in the middle of a six week gap in testing or for that matter over the top on occasions. My analysis of the trends say not but I can't guarantee it.

I believe that apixaban also carries less risk of inter-cranial bleed than other anticoagulants but I could be wrong here. Since neither drug is a clot busting one that is a bit of a red herring or did the clot allegedly form whilst you were taking apixaban?

Since we are not medically trained I really would suggest that you discuss this with your EP who is after all your main carer.

[10gingercats]

Follow your EPs advice for the time being and research widely to try and present your EP with a good case if you want to change to Apixaban.If he has evidence he may then agree with you .A couple of months on Warfarin will not harm you.

[souljacs4]

If you put Warfarin v Apixaban in the search box top right hand corner there were a lot of posts on here about the subject a few weeks ago

[Barb1]

It is normal practice to be put back onto warfarin until clot goes. Then you can go back to a DOAC.

[cali111 in reply to Barb1]

Thank you it saves me asking. They are of the mind that the thrombus will not reabsorb so surgery maybe the only answer.

[Barb1 in reply to cali111]

Why have they come to that conclusion. Mine took nearly a year at a therapeutic range of 3.2 to 3.6

[cali111 in reply to Barb1]

As far as I know the thrombus is too old, maybe I should be glad it didn't move and cause mayhem!

[Rosy_Holly]

I have read that there are 17,000 Court cases going on re DOAC's in America at the moment. Hopefully we will hear the results and also the evidence presented.

[cali111 in reply to Rosy_Holly]

Is this to do with a side effect or the protective level?

[Rosy_Holly in reply to cali111]

I am away at the moment will personal message you when I return and can look up the details on my papers at home.

[Hidden in reply to Rosy_Holly]

Oh my goodness, and tonight's the night I start apixaban, as the INR is down to 1.3 now. I've felt very uncomfortable with not taking anything!

[Rosy_Holly]

Anti coagulants are a very personal thing. As are any drugs. I feel happiest checking out all I can. That is just how I am. My GP has been very supportive with coping with all of my queries. As my eldest grandaughter said best to go with what you are comfortable with and remember tomorrow is another day.

[Lulu777]

I have been on Warfarin for 9 years. I have my own Coagucheck machine so am able to test at home for peace of mind that my INR is in range. However my GP surgery told me I was over ordering the INR testing strips which is why I decided to change from Warfarin to Apixiban. I first took Apixiban twice a day last Thursday but I woke up this morning with a headache and still have it now. Having read more on Apixiban (especially reading from American forums) I'm quite worried as many posts are extremely negative and some say not to touch Apixiban. Other posts say about severe hair loss. I'm really worried now and don't know which way to go forward.