Apixaban vs Warfarin?

[Chris1945]

My GP has just offered to put me on apixaban and take me off warfarin, he said that if I had presented now with my first episode of afib, I would automatically be put onto it and not warfarin. This sounds like an excellent idea because there are no dietary restrictions which as a veggie means I can indulge in lots of the green stuff i've been avoiding (and missing!).....or can I? I'd appreciate any advice please...thanks. x

[BobD Volunteer]

Well as we have often said, make warfarin fit your diet not the other way round but c'est la vie. DOACs such as Apixaban do not normally have dietary restrictions which is why so many people choose them.

[Finvola]

The only things I was told to avoid on Apixaban are aspirin, NSAID’s and anything with St John’s wort. There was advice on this forum that grapefruit juice should be avoided too.

Enjoy platefuls of greens!

[Wightbaby]

I have been on Warfarin for over 5 Years and eat salads and green veg every day. You don't have to give up "greens"........just keep the amount you eat fairly consistent. If I had to cut them out, I don't know WHAT I would eat!!

My INR's are rarely out of range, and if they are, it's due to other things, like "holiday" diet, being unwell etc etc. I have written a piece titled "Don't give up your greens" and it is printed in the AF magazine.

Then again, if you have been offered Apixaban......you may as well go for it!! : )

[10gingercats]

I was on Warfarin for several years and found it did interfer with my need to eat a lot of 'greens'.For this and other reasons i moved on to Apixaban. best thing I ever did.

[Wightbaby in reply to 10gingercats]

Hello there

Hope you are well!

Still no plans to visit the island yet?

[Bagrat]

I ate lots of greens on warfarin with no problem. As BobD said it is not a problem, in fact it seemed to help as " ironed out" minor variations because of vit k in other foods we tend to forget.

Am now on Apixaban which is fine too although I am having regular blood tests as one liver function test is up a bit which of course may be unconnected as didn't have this test before!

[Thomas45]

The great advantage of Warfarin is that it's been used for medical purposes for 70 years. Its main drawback is testing to be in the correct range of INR, but I get round that by having bought my own Coaguchek meter.

I can eat what I want, including a daily intake of greens. I think you shouldn't eat some aspect of cranberries, but that's no problem as I never have liked them.

If you eat greens daily your Warfarin dose reflects that. When I had appendicitis I found it took a lot of intravenous vitamin K to bring my INR down from 2.7 to 1.0. At 2.30 pm on a Saturday I was admitted to a ward, and I was started on vitamin K. 12 hours later, at 2.30 am on a Sunday morning I was taken to the operating theatre to have my appendix removed..

The disadvantages of the newer anticoagulants is they've not been around long. Nobody knows the long-term effects of them. You still need some testing of the effects of them on your other organs e.g. liver and kidneys.

[mandysmith34 in reply to Thomas45]

You also cannot take them if you have a mechanical valve!!!! My view tends to be, "if it ain't broke, don't try fixing it!"

[Wightbaby in reply to Thomas45]

With you on this......I think Grapefruit is another on the "definitely not" list too??

Please correct if wrong.

I wish Coagchecks weren't so expensive!

I guess you still go for an official INR check too?

[Thomas45 in reply to Wightbaby]

Grapefruit is a prohibited food for Statins, but as far as I have been able to research you can still drink grapefruit but not at the same time as taking a statin tablet.

I take my Coaguchek meter to my local medical centre once a year to check it's still working properly. A couple of months ago I had two colonoscopies, the first was diagnostic so I was told not to stop Warfarin. It found 4 polyps so I had a second colonoscopy after stopping Warfarin to have them removed. The surgeon said I couldn't have the 2nd colonoscopy until my INR was at 1.0 or 1.1. I was told to come off Warfarin 4 days before the procedure. As it happened 8 days before the 2nd procedure my INR was 3.9 so I stopped then. 4 days before the procedure the INR was at 1.3 where it remained for the next 4 days. At hospital their INR meter also showed my INR to be 1.3, so they went ahead and removed the polyps.

[Wightbaby in reply to Thomas45]

Glad it all went well in the end.

MY GP is extremely "anti" self testing anyway!!

[Thomas45 in reply to Wightbaby]

Your GP ought to read NICE guidelines on self-testing nice.org.uk/guidance/dg14/c...

[Dodie117]

I changed for convenience and no problems. It is a lot easier.

[Chris1945]

Thanks everyone for your responses, really appreciate them. I know in moderation green veggies are ok to take when on warfarin, my problem is I like them so much that I have no conception of the word 'moderation'....I could cheerfully tuck into a whole plate of kale, spinach, broccoli et al on a regular basis, strange I know, as most people try to avoid them! Nor am I a fan of grapefruit so Apixaban sounds like a good idea. I will discuss further with GP and then decide but thanks again to all for your advice....ever onwards!