NOACS

[Dodie117]

Did you all see this already and am I just slow??

pharmaceutical-journal.com/...

[BobD Volunteer]

Interesting but I think I'll stay on my warfarin thank you.

[Dodie117 in reply to BobD]

I’m on apixaban which seems to fare rather well.

[Hidden in reply to Dodie117]

Me too, so fingers crossed!!

[Hidden in reply to BobD]

Hi Bob do you get any side effects or downsides to being on Warfarin. I think I would almost prefer to be on it rather than Edoxaban. Thanks Sue

[BobD Volunteer in reply to Hidden]

I am lucky ? in that my INR is pretty stable and seldom drifts out of range. I have no problems apart from slightly brittle nails so why would I want to change. I have always looked on NOACS/DOACS as a great alternative to warfarin for those who are not as lucky as I am. After fifteen years its a no brainer to me.

[dedeottie]

Me too. X

[Hidden]

Hi lallym,

No I didn't see this BUT as I don't take any such drug it doesn't much worry me. I'm on Warfarin. I agree with BobD.

But I would add the following from the Australian Government, Dept of Health, Therapeutic Goods Administration. Note how early the reviews were undertaken - one in Aug 2012 and the other in May 2013 !!

tga.gov.au/alert/dabigatran...

John

[Dodie117 in reply to Hidden]

This report was a bit more recent - Jan 2017.

[Hidden in reply to Dodie117]

Yep, I realise that - BUT - the point I was making is that at least so far as Dabigitran (Pradaxa) is concerned this drug is still suspect after some 5 years, from the date of the Australian study to the one you refer to. I should have made my point clearer.

I would have thought that drug companies could have addressed these issues in 5 years. Hmmmmm !

Maybe they just don't care.

[CDreamer]

Hi Lallym - I am wondering what is is that was of interest to you?

There is NO way I was ever going to take Wafarin so I have only ever taken DOACs as they are now called. I have taken eithe Dabigatran or Apixaban for 4 years so it think I read every article and report written.

There is always a risk/benefit ratio to be studied which will vary.

[Dodie117 in reply to CDreamer]

I took warfarin for about 2 years and self monitored most of the time. I had no great problem with it but found the need to monitor regularly a bit of a pain. Also diet restrictions but I had it fairly under control. Apixaban at least as safe (I judged) and more convenient.

This was of interest to see what the latest research was saying about pros and cons of various anticoagulants.

[CDreamer in reply to Dodie117]

That makes sense

[Vonnieruth]

Research has to be done we all know this but all this can cause more Anxiety for some who don't like taking medication in the first place Sometimes it can cause more harm than good having certain info brought to life Surely the medication would not have been past if the good didn't out weigh the bad

[CDreamer in reply to Vonnieruth]

I think that very much depends on your psychological make up as to whether you find studies helpful or not.

Personally I need to know as much as I can to make an i formed decision and know from experience that all substances can be toxic - even water - to some. Research is essential and making that information widely available is also essential - but you don’t have to read it if you don’t find it helpful.

I do not believe that because a drug has been licensed it is either ‘good’ or ‘bad’ for me. It will have the potential to help and to harm and therefore I want to know how it works, what is known or not known and how was it tested and how is it monitored in order to make an informed choice.

[Vonnieruth in reply to CDreamer]

I agree I was staying that those who have anxiety may find it disturbing and make anxiety worse Thus it is sometimes a bad thing to realise everything on the internet Things change and what's there may not be true now with continual research I feel like I'm in a no win situation here

[CDreamer in reply to Vonnieruth]

And I feel I have choices and options. Glass half full or half empty? I’m glad to be alive and I’m not frightened of dying. In fact I don’t find the idea of dying from a stroke or bleeding out is a bad way to go, I’m much more concerned about surviving and helpless. Much better than fading away very slowly with dementia - as my mother in law is now doing - something I know she would have hated.

[Buffafly in reply to Vonnieruth]

Our advice to anxious people is 'Don't Google!!!' unless you go to an official website such as NHS, AFA or BHF. Also try not to read the results of other people's googling.........

[jennydog]

Iallym : Thank you for this. It is very interesting.

Postings like this are what this forum is all about. I strongly believe that knowledge is power which is why interchanges of information on this forum are so important.

[Buffafly]

Even more pleased I changed to Apixaban then.

[NooNoo14]

I am currently on a drug trial for another serious health problem and the only anticoagulant I am allowed to take is Apixaban - not sure why!

[Hidden]

I am the same as Jennydog.I like to know the ' ins and outs 'of everything even if l don't like what l hear .What's the point of burying one's head in a bed of concrete...

[Dodie117]

Glad it was of interest. Like most I like to know what I’m taking but realise this is not the same for everyone.

Good luck to you all whatever you are on 🍀

[Upsky]

Thanks for posting, I’m on Rivaroxaban and just been called to come in after 6month blood test check, last time I was just represcribed without having to go in. My recent cardiology check after ablation in April, I was told although these new drugs are licensed they have no long term data to go by for long term effects, I guess it’s pros and cons and weighing up the risks, but I may just see if I can find time for warfarin instead.

This also shows how important it is to report side effects however large or small.

[42boston]

Recently I asked a prominent cardio vascular specialist for his advice on wafarin vs the NOACs. His comment was that warfarin had been around for 100 years and the bad aspects were well known and could be dealt with. On the other hand the NOACs still had not received NICE approval for long term use and NOAC pharmaceutical companies had been trying to get NICE approval for the last 10 years. So I stayed with warfarin.

[doodle68 in reply to 42boston]

[Quote = Boston42 On the other hand the NOACs still had not received NICE approval for long term use and NOAC pharmaceutical companies had been trying to get NICE approval for the last 10 years. ]

Really that comes as a surprise to me , see below....

[Quote =NICE ''The 4 NOACs currently licensed in the UK are apixaban, dabigatran etexilate, edoxaban and rivaroxaban. NICE has issued technology appraisal guidance on the use of NOACs in several clinical settings. These are summarised in table 1.'']

nice.org.uk/advice/ktt16/ch...

Had they not been approved for use by NICE doctors would not be allowed to prescribe them.

[doodle68 in reply to doodle68]

Post above continued..

I won't list all the NOACs but here is the NICE notification of funding and approval for the one I take Apixaban;

[National funding/access decisions

NICE decisions

NICE TA245

Apixaban for the prevention of venous thromboembolism after total hip or knee replacement in adults (January 2012)

NICE TA245

Apixaban is an option for the prevention of venous thromboembolism in adults after elective hip or knee replacement surgery.

nice.org.uk/TA245

NICE TA275

Apixaban for the prevention of stroke and systemic embolism in non-valvular atrial fibrillation (February 2013)

NICE TA275

Apixaban is an option for the prevention of stroke and systemic embolism in non-valvular atrial fibrillation in accordance with its licensed indication; with one or more of the following risk factors:

previous stroke or transient ischaemic attack

symptomatic heart failure

age ≥75 years

diabetes mellitus

hypertension

The risks and benefits of apixaban compared to warfarin, dabigatran etexilate, and rivaroxaban should be discussed with the patient.

nice.org.uk/TA275

NICE TA341

Apixaban for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism (June 2015)

NICE TA341

Apixaban is an option for the treatment and prevention of recurrent deep vein thrombosis and pulmonary embolism in adults.

nice.org.uk/TA341]

[CDreamer in reply to doodle68]

Mostly agree but NICE are only guidelines - they do not regulate. I’m prescribed several drugs not NICE approved - always at the discretion of the CCG - but then NICE are not always up to date & as far as can tell - they more of a concensus of opinion of efficacy than a regulations body. We don’t have a body that regulates - only one that licenses?

Please someone correct me if I misunderstand.

[Dodie117]

I believe NICE has approved DOACs.

[Vonnieruth]

Good topic to discuss then Good job we all have different opinions to Mr Google has made millions in money and millions in anxiety I guess

[AnneWorner]

Thanks for posting this. I'm generally cautious about taking new drugs. I'm sticking with my coumadin.

[Dodie117 in reply to AnneWorner]

🤙