Some folk being swapped from warfarin to DOAC

[Bagrat]

OH is still on warfarin. Went for INR today (next in 10 weeks) and asked if this was happening. There has been discussion in the practice evidently but was told apparently because of the number of people being swapped there may be a shortage of apixaban ( their DOAC of choice). Because like BobD he is always in range he will not be swapped. Has anyone else heard of shortages? I know there are always production delays of some meds and they tend to be cyclical so hope this too shall pass

[Finvola]

Not heard of shortages so far but we need to bear in mind where the raw materials and the drugs themselves come from. I did wonder at one point whether Warfarin might become the anticoagulant of choice . . . or indeed of necessity.

[R1100S1 in reply to Finvola]

Hope not my INR was all over the place on warfarin, worrying so.

[sotolol]

Hello. I can’t get any Dabigatran ( Pradaxa). Been waiting two weeks. They say a supply problem?!

[Bagrat in reply to sotolol]

I admit to ordering a week early for all meds ( the most we are allowed to) since the uncertainties of Brexit so have about 3 months supply of all mine . Also there is a glitch on the list and my anti cancer hormone seems permanently available to reorder ( but I haven't!!)

[Wightbaby]

I did a post on this the other day......entitled "All patients to come off warfarin?"

Like Bob, I am very stable on Warfarin...but there was no debate....i was told "you have to come off, so we don't risk you or us, by having to do INR's".

So I start Edoxaban the day after tomorrow. the nurse said i only have to miss one dose of Warfarin because my INR is stable and was 2.5 last time....supposed to have beforehand but that obviously is NOT going happen!!

All surgeries on Isle of Wight seem to be doing this!

[Bagrat]

Yes I saw your post Wightbaby and it was that that prompted me to get OH to ask while at surgery. Thanks

[sotolol in reply to Bagrat]

I saw that too. So I asked. So thank you Wightbaby

[Mrsvemb]

This isn’t specific to Apixaban, but my pharmacist told me that they are having problems sourcing a lot of drugs at the moment. I have to have a particular brand of Nebivolol but they cannot get it at the moment. I can hang on a bit longer, but not sure what I will do if they can’t get it.

Val

[Bagrat in reply to Mrsvemb]

I suppose inevitable really but sorry you have this added concern

[reinaway in reply to Mrsvemb]

Is it the Teva brand that you find ok?

[Mrsvemb in reply to reinaway]

No it’s the Glenmark that I find OK. I was given Mercury and they caused really bad nausea, so I asked the pharmacist to issue the Glenmark. That was well before the Coronavirus problems. I haven’t tried any others yet, but pharmacist suggested that I take one pack of Numark to try as they have that in stock.

Val

[reinaway]

I can only take one particular brand of Nebivolol as the others give me violent stomach pain. I am having trouble getting that brand at the moment and on comparing the different brands from information on the leaflet inside I can see it is the different fillers that they use. The drug has been brilliant at controlling my AF and I don't want to have to change it.

[Mrsvemb in reply to reinaway]

I don’t want to change from Nebivolol either. I changed from Bisoprolol last October and have not looked back. I have far less AF episodes now and feel so much better. I checked the ingredients too and as you say it’s the fillers.

[MarkS]

I've just picked up my latest lot of warfarin so my practice seems to be carrying on as normal at least. If you are on warfarin, then a Coaguchek is invaluable.I don't understand why the NHS doesn't provide them for free. The cost would still be a lot less than an NOAC and if properly monitored, warfarin is at least as effective. In these times we need to save the NHS money where we can.

[Wightbaby in reply to MarkS]

Seems to be regional, Mark. and of course some folk have to take Warfarin for other medical reasons.

[Enjoy]

I so wanted to stay on apixaban but one of my other tablets prevents this. I worry about nurse coming in to me after several other people. I tried to buy an anti coag machine, but no luck. Anti coag Nurse is now trying for me.

[Bagrat in reply to Enjoy]

Oh do hope she succeeds. I read far too much and have discovered possible interaction with apixaban and tamoxifen. I am however studiously denying it will be an issue as advice is no change in dose and monitor! Pharmacist had nothing in her book of words. Ditto flecainide and tamoxifen. But am on v low dose flec and again pharmacist says I must trust my medical professionals!