Warfarin vs Apixaban

[Echinopsis]

Read with interest the earlier discussion re the benefits of both.I was toying with the idea that I may come off Warfarin. Are there any long term side effects from being on it? I suppose this all depends who you are. One respondent in the earlier discussion said they had been on Warfarin for 30 years, so there is almost an answer to my question.I think I may have read somewhere that it causes the calcifying of arteries as opposed to the calcium being put to good use re the bones.Any thought / experience regarding long term side affects from Warfarin that may have been heard about would be of interest.I suppose that the Apixaban has not been around long enough? to have such long term side effects attributed to it?Thanks

[Jenbo6]

I haven’t had any experience of warfarin but have used apixaban for over three years. I didn’t want to be tied down by blood tests and dietary concerns. I pop a pill twice a day and forget all about it! Brilliant !!

[10gingercats in reply to Jenbo6]

That's why I take Apixaban.Nowadays.No blood tests plusI am enjoying lots of spinach,watercress and 'greens' generally plus cranberries!

[Echinopsis in reply to Jenbo6]

Thank you.Seems the way forward.

[Echinopsis in reply to Jenbo6]

Sounds great. Thanks so much for this

[Echinopsis in reply to Jenbo6]

Am I right in that Apixaban works differently to Warfare in that INR levels don'the apply.? So it is not necessary to have checks to see how thick or thin your blood is.

Seems good that this medication can put your blood at the correct level straight away.How often do you need to have blood checked to ensure it is workingAlso,does one just stop taking the Apixaban the day before an operation or having a tooth out then you carry on after or do you not need to stop taking it at all?

Thanks again.

[BobD Volunteer]

The most famous person to first use Warfarin years ago was Dwight Eisenhower back in the forties so it has been around nearly as long as I have. I think we would know about any real problems by now. I can't claim thirty years but fifteen yes.

That said I do understand that DOAC's are actually on balance marginally safer.

[Echinopsis in reply to BobD]

Good point and makes a lot of sense

Thank you.

[wilsond]

My dad was on Warfarin long term ,over 15 years and had 3 major operations during that tine,no problems

[Echinopsis]

Thank you.Others have mentioned this and confirmed no problems with it.My Father had TIAs and there seems to be some agreement betwee respondents that this and possible strokes are less harmful for some reason if one is on Apixaban. SO, let will double check this with my GPS in due course.

[Annekw]

Hi people, whilst reading this weeks British Medical Journal my husband came across this article!

DOAC’s are at least as effective as Warfarin, safer to use and easier for patients to use! It also says Apixaban 5mgs twice daily ranked highest for most outcomes and was cost effective compared with Warfarin!

There is also a paper on the original research.

This is good news for all of us AF people!

[Mike11]

Note that whilst NOACs may be better than warfarin, for me I do take far longer for any cut to heal on apixaban than when on warfarin which can be a bit of a pain

[JulesAF]

I’ve been on Warfarin for 13 years with no problems. I’ve tried two of the Noacs (Pradaxa and Eliquis) with terrible side effects. I’m sticking with Warfarin as I eat what I like, drink socially and lead a normal life style holidaying abroad etc. Naturally I don’t eat buckets of Kale or spinach but everything in moderation. Good luck with it all.

[Echinopsis in reply to JulesAF]

Thanks to everyone who has commented. But what about the suggestion that Apixaban is far better to be on if you suffer a 'bleed' TIA? My Father suffered from TIA's which is what was going through my mind when considering whether to change to it from the Warfarin.

[MarkS]

The trials of NOACs against warfarin were all against warfarin users with poor INR control. Get good INR control and warfarin is just as good and safe. To do that I'd recommend a Coaguchek monitor so you can self test which is easy peasy. And 40% less cancer risk with warfarin.

[Echinopsis in reply to MarkS]

Thanks to everyone who has commented. But what about the suggestion that Apixaban is far better to be on if you suffer a 'bleed' TIA? My Father suffered from TIA's which is what was going through my mind when considering whether to change to it from the Warfarin.

[MarkS in reply to Echinopsis]

I've never heard of a bleed TIA. TIAs seem to be caused by clots. My father also suffered from TIAs and those were clots. Warfarin can cause bleeding if the INR is too high. Well controlled warfarin should not cause bleeds. To my mind, warfarin is safer because its effect can actually be measured. Don't forget, warfarin was not self tested or self managed in these trials. With modern methods of control, I believe warfarin to be just as good if not better than the NOACs.

[Echinopsis in reply to MarkS]

Thanks so much Mark.

[brit1 in reply to MarkS]

cancer??? does Eliquis cause cancer???

[MarkS in reply to brit1]

No the NOACs do not cause cancer. It's warfarin that cuts the risk of cancer by 40%, see:

jamanetwork.com/journals/ja...

[Echinopsis in reply to MarkS]

Thanks again Mark.

[Hidden in reply to brit1]

Hi Brit1

The wording in the Sun article about the new anticoagulants is in my opinion at best misleading and arguably plain wrong.

As Mark said there is absolutely no evidence that any of the newer anticoagulants cause cancer.

Nobody should for a moment consider stopping taking their AC because of this research. These new drugs have stopped hundreds of thousands of people having a stroke.

ELIQUIS DOES NOT CAUSE CANCER.

As Bob would say, end of story.

[Echinopsis in reply to MarkS]

Thanks again Mark.

[Blooto in reply to MarkS]

Hello MarkS

If INR is usually stable with checks every 6 weeks, should INR checks be carried out more frequently anyway to make sure it really is stable?

[MarkS in reply to Blooto]

Hi Blooto,

It's probably not necessary in your case. I test every week but then I have a very varied diet and I like to catch any deviations before they come a problem. I've found through experimentation that INR changes by a relatively small amount each day, it's trends that can cause problems. So if my INR gets above 2.8 I reduce my dose by 0.5mg, or v.v. if below 2.2. If I have a meal particularly heavy in greens, I take an extra 1mg just for that evening. It works for me and keeps my INR in range 98% of the time.