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AF Association
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Anyone taking Coumadin?

Most docs now prescribe Pradaxa, Xerelto or Eliquis, but Coumadin is still the safest in terms of reversal in the case of bleeds. I understand the convenience of the newer drugs -- big Pharm has spared no money telling us this -- but wondering if anyone taking Coumadin could tell me how much of a bother (or not a bother) is it to find and adjust the dose.

Jim

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I still take Warfarin (Coumadin). I have my own INR machine, and take my own reading at least once a fortnight. A lot of people say you can't have much in the way of salad etc. but it is a matter of consistency. I eat a large salad every day, and have little problem maintaining a stable INR. I'm still not sure of the newer noac's. Sometimes the gp's are swayed by drug companies into giving patients newer drugs, but my feeling is 'better the devil you know' at least for the time being. Maybe in time when more facts emerge about the long term effects of taking the newer drugs I might feel differently, but for the time being I'm staying on Warfarin.

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Hi

For myself I was unable to maintain a steady reading on warfarin , hence now on one of the new drugs.

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Here in Spain, I take Sintrom (acenocoumarol) a very similar drug I'm told, and , like Gmc54, took a little while to work out when/what (not) to eat but seem stable now(Touch Wood!).

What i didn't realise, but worked-out for myself, was that the very small amount of Vitamin K in my Multivitamins, prescribed by my haematologist not my cardio, was drastically skewing the INR readings.

Roger

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apixaban is great if you have a busy life warfarin is a bit off a pain if you cant get your INR at the right level its what is good for you

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I have taken acenocoumarol (a derivative of warfarin) since day 1 - about 10 years ago - and find it very easy to regulate the dose. I eat fish, but apart from that, I`m totally vegan, thus consuming much green vegetation. I find that by sticking to a fairly regular weekly diet, it`s very easy to regulate my anticoagulation, and can go for 2 to 3 months between checks.

2 x 1 mg tablets daily of Sinthrome (trade name for my acenocoumarol) keeps me within a whisker of my target. This will vary between individuals. Ask your GP to try you on Sinthrome. It`s very inexpensive so will not bankrupt his practise!

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My understanding is that the new drugs are safer in regards to bleed risk and Vik K reversal can take up to 36 hours to take effect.

Personal choice but I refused to consider Wafarin - too hit and miss for my liking and am very happy on Apixaban,

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If you have a mechanical heart valve, you have no choice. Warfarin is the only anticoagulant that works. It's a doddle. Buy your machine, test yourself, work with your team to dose if necessary. Not an issue

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Warfarin has been around for years and for some of us is our best friend. I am one of the lucky ones who manages to stay in range a good % of time (better than 85%) but for those who can't then the DOACs can be life savers.

The reversal thing is a red herring for two reasons. Few places have readily available the reversal agent for warfarin and Vit K when used takes some time to work. DOACs have a short half life and soon loose efficacy. Some trials claim DOACs are safer but for one who has been taking warfarin for 15 years with zero problems why would I change?

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Hi there, I’m taking Coudamin as I have chronic AF. I have been doing so for 15 years. I’ve tried the new (all three) anticoagulants at different times and had side effects with each. Padaxa was vile - terrible reflux problems.

With Coudamin, I average about 2 blood tests a month and don’t find it highly disruptive. I have absolutely no side effects with the drug. And I actually feel a sense of relief getting the results after each blood test. I have my own test kit for when I travel abroad. I lead a very busy life - own a company, loads of travel and a fair amount of stress. Apart from not overdoing the Vit K, I don’t have any complaints about warfarin. Good luck. 💕

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I am on Coumadin for years now. Tried Pradaxa, gave me terrible stomach upset. Then tried xarelto and had blood in urine do had to stop that. I was keeping my inr in the right level for some time. Now one month it is high, the next low. Try to eat greens at a even level at all times, so I don’t know😏

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I used to take Pradaxa. They now have a reversal agent for it that works rather quickly.

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I have been taking Warfarin for 11 years with no problem, It used to be a bit of a pain having blood tests taken from my arm every 6 weeks at the local hospital.

For the last few years I only have to go to my doctors for a pin prick finger test which is easy.

I haven't avoided salads and have had no problems.

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It is no bother at all monitoring your INR and adjusting the dose if required. It takes about 2 mins to test your INR on a Coaguchek. That proves you're in range and consequently properly anti-coagulated. INR testing is a good way to ensure you take warfarin every day. In a real world study recently, warfarin did better than the NOACs probably because compliance was higher because you could actually see the anticoag results.

You're right, warfarin is still the safest in terms of reversal - Vit K if not urgent and PCC if urgent which reverses warfarin in about 5 to 10 minutes, and is widely available in the UK.

Having said that NOACs are great if you cannot stay in the right INR range more than 60-70% of the time.

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I just want to thank everyone for all your informative and thoughtful replies. Lots of options and decisions with afib! Didn't realize so many people were still on Warafin, but I recently read that a very prominent politician was taking it. Figured they probably had a pretty good doctor so thought it might worth looking into.

Jim

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