Blood thinners

[Meeie]

Which do people think is the best blood thinner? I have been told warfarin is reverseable if you bleed Xarelto is not.

[Hidden]

Yes warfarin is reversable but it is difficult to maintain a therapitic blood level( INR) which has to be in a certain range to protect you, thus requiring frequent blood tests. The newer anticoagulants are thought to be better as there is no theraputic level to maintain. They are in your system and do their job on a more level basis. Down side to all the newer meds are that they are expensive.

[BobD Volunteer]

If you mean anticoagulants then you have such a choice these days. The newer oral anticoagulatnts ( or DOACs) have the advantage that they do not need regular blood tests to check that you have the correct INR. the rate at which your blood clots. None thin blood as such. Warfarin is checked by INR testing and if like me you are lucky enough to have a steady INR and remain in range most of the time then this is a good drug to take. For me diet is not and never has been a problem although some people do find difficulties staying in range.

Of the DOACs the question of reversal agents is largely a red herring. The half life of these drugs is short and in any event only a catastrophic injury is likely to present a problem as there are ways and means to deal with any bleeds. For minor injuries the usual pressure and plaster usual work fine. The major drawback with these DOACs would appear to be side effects such as digestive problems from what we see here.

Whilst there is an actual reversal agent for warfarin it is not always available and the accepted wisdom of taking lots of VIt K takes time so on balance there really is no difference or what is best. What is best for YOU is all that matters.

[barbara2 in reply to BobD]

I think you explained this hard to answer question very well. Perfect!

[Hidden]

Some people love warfarin because its effectiveness can be measured with a blood test and that's fine when the result is good. It can however get beyond its therapeutic range and that's where its antidote comes into play, bringing levels down to an acceptable level. The antidote's usefulness is probably far too slow to deal with a serious bleed.

As Bob says, the lack of one for the newer drugs is a red herring and they make life very simple - all you have to do is to remember to take them.

[pat1234567]

I joined a Facebook page for people who have a bloodclotting disorder due to APS, and time and time again I read that people have been told by their hematologists that Warfarin works better to prevent clots than Xarelto. Many have claimed to have clotted while on Xarelto. I did not research this and do not know whether that only applies to people diagnosed with APS. But just Repeating what I heard. I am going through testing for this disorder now, and personally I prefer to take Xarelto over Warfarin because I don't want to have to worry about diet and INR levels. But if my hematologist tells me that warfarin is necessary to prevent clots, then that will be the one I take.

[AnneTS in reply to pat1234567]

Yes Pat. If you have APS the newer anticoagulants don't cut the mustard and Warfarin is the "drug" of choice. Even Warfarin is not the best for everyone with APS and they often are better served giving themselves daily injections of Heparin.

[Raoudha in reply to pat1234567]

Please do you mind to give me group name on FB

Thank U

[pat1234567 in reply to Raoudha]

Raoudha, the name of the Facebook group is Antiphosphlipid Syndrome (APS/Lupus Anticoagulant).

m.facebook.com/groups/41913...

3243 Members.

[Raoudha in reply to pat1234567]

Hey pat

Appreciate your feedback thank U so much

[Paddinton]

While Warfarin is reversible, paramedics do not carry the drugs to do this

[Hidden in reply to Paddinton]

In England I had it k drops to reduce INR. On a Greek island I had vit k IV when on Warfarin

[icklebud99]

I have had minor cuts and bleeding which has stopped quickly, didn't even notice the difference and I am on Riveroxiban.

[AnneTS]

After 30 years on Warfarin I would plump for it any day on the following grounds:-

1. It has been successfully used for anticoagulation for many, many years without any major incidents being reported.

2.If you have a bleed there is an antidote.

3.If you self-test you have control and can monitor what your INR is doing. This is particularly useful when you go to far flung lands on holiday and try new foods etc.

4. If you self-test and are on Warfarin it is the cheapest option for the NHS Even if you don't self-test it is still the cheapest option for the NHS.

5. Rumours abound that the management of anticoagulation will be placed in the hands of your GP instead of at regular hospital clinics. If this is the case it will make visiting clinics much easier for patients.

Of course the newer anticoagulants provide fresh choice for the patient and are great if you fit into the category of patient for whom these newer oral anticoagulants are designed. I am not and after so many years on Warfarin the procedures and testing etc. have become a way of life that I easily fit into my daily schedule.

Anne

[Ianc2 in reply to AnneTS]

Item 3 - I live in Wales, after initial tests in my local hospital the management of inr levels is being carried in my local surgery - much easier to park.

[BobD Volunteer in reply to AnneTS]

Most GP surgeries already manage anticoagulation from my experience. It changed about six years ago or more in most areas.

Little thought for the day here. Most people think that warfarin has been around for ever. I know I did which is why I was most surprised to learn that it has only been popular since WWll and in fact the first public figure to be prescribed it was (roll of drums and Star Spangled Banner) General /President Dwight Eisenhower. Not many people know that as Michael Caine would say. This has been a public information broadcast. lol

[AnneTS in reply to BobD]

Thanks Bob for the info on when Warfarin was first being used! I love all the knowledge that is on this forum. Ann

[Zozzy]

What Bob said. I was on Xarelto. It doesn't thin the blood, it slows down the clotting. Your blood will still clot, it will just take longer. But not so long that you need to worry. I cut myself a couple of times while on Xarelto, and both times my blood clotted properly. When I cut my finger with a knife I just needed to wait a bit longer - at a guess I had to keep my hand in the air squeezing with my thumb for about twice as long.

[ILowe]

The drugs have different mechanisms of action. If you have an Artificial Heart Valve then you are obliged to take Warfarin because it protects you in the places which count for the problems with the valve. Those having AF only have more choice of medicines.

I carry one of the many special dressings. I like Savlon Alginate dressings, and packets of Celox granules for deeper wounds. See healthunlocked.com/afassoci... and healthunlocked.com/afassoci...

[barabas]

My EP prescribed Eliquis, rather than Xarelto. He said there is an immediate antidote to reverse the effect, the antidote is very expensive, but he has personally only used it once in last 10 or 15 years. He also said that the increased bleeding risk with Eliquis was about the same as taking aspirin. After being on it for several months, don't see much difference in bleeding from cuts, scratches, etc vs. from when I was taking one baby aspirin a day. My understanding is that Eliquis and Xarelto are very similar drugs, but some patients tolerate one or the other better. Both are extremely heavily advertised in US by the pharmas.

[KMRobbo]

I have been on pradaxa , which is dabigatran etexilate for three months so far with no problems at all. I am aware that some people have reported acid reflux on them and are given lansoprazole to combat this. I was on pradaxa 25 days prior to an ablation, was given the lansoprazole after the ablation and I took them for a while. However I stopped as there are potential side effects from the use of this drug also and as i had no reflux without them I thought what is the point? I have had no issues since with pradaxa at all.

THERE IS an antidote to pradaxa , ( I think it was developed at the request of the US drug authorities) . I was going to try to get some but I have never bothered for the reason I am only temporary on pradaxa for another month.

I am (was?) terrified of A/C as my hobbies / exercises include mountain scrambling with some climbing, road and off road cycling, running including across country rather than roads, and motorcycling. Any one of these could result in a slip, trip, fall and bang and i was most worried about a bang to the head.

Oddly enough the cycling is probably the most dangerous as, with logical analysis, I have quite a record of minor crashes and bumps at cycling (with bruising) whereas I have never actually, in the last 30 years, crashed my motorbike or fell off a mountain ! But still the illogical fear remains! ( what If?).

I just decided to pack in cycling for 3 or 4 months while I was on pradaxa (weather lousy anyway).

The other upside in my feeling on this anticoagulant is the lack of bleeding. If I cut myself, as I did last week , it took 20 minutes to stop bleeding completely This is not much worse than normal for me, and is far far better than what happened to me when my GP put me on low dose aspirin and even a shaving nick took 45 mins plus to stop. Bruising is not an issue either. I walked rather quickly into an open drawer whilst on pradaxa and got a really painful bang on the thigh - there was virtually no bruising . I was very surprised as I would have expected a lot more. Again when I was on low dose aspirin I dropped my road cycle on black ice doing 0.5mph whilst doing a u turn in a side road, and landed on hip joint. It was a "nothing" bump. 24 hours later I had a bruise/swelling from below my knee to above my hip bone which turned black later - I looked like I had been hit by a car! ( needless to say I stopped the aspirin).

Consequently my experiences with pradaxa have completely changed my feelings with anti coagulants. I am still worried about large bangs but less so as I now believe they will have to be very large bangs to be a problem which may well be a problem at my age anyway (58) even without the A/C.

I will be happy to stop taking Pradaxa in another month, but in future if I have to take an A/C then I will be much much less concerned than I was prior to this experience.

Of all the 7 drugs I have taken since I have had AF pradaxa has the least side effects (none)

Normal warnings:

different drugs affect different people in different ways: Good for me may not be good for you.

I have only been on this one anti coagulant so I cannot compare with others.

I have only been on it 3 months, so a much longer timescale may raise some issues. (Not read about any though - Dr John Mandola seems to be a fan of pradaxa so look at his web site).

I am not medically trained so this is just my observation on myself with my conclusions to some minor injuries.

I hope this helps. (Sorry it is so long.)

Regards

[fnurd]

Dabigatran is known to have a risk of stomach issues, as it brings its own acid with it. Booze is not thought to go with it very well for this reason. Apixaban is good, and has been shown to be better and safer than warfarin in the real world, probably due to the difficulties of getting perfect INR control with warfarin. Riveroxaban is very convenient astaken only once daily.

[James_GA]

I've been taking Eliquis now for 4 months and I have had no problems. I cut my finger (just short of needing stitches) about a month ago and it didn't seem to bleed any more than usual.