Changing from Warfarin to Apixaban

[Chris1945]

Just had a conversation with my GP re changing from Warfarin to Apixaban for my PAF and he has, reluctantly, agreed to do so because he feels that patients who've been on warfarin for a long time (in my case 6 years) should stay on it. The reason I want to change is because I'm veggie/vegan and want to eat a great deal of green stuff and cauliflower etc., which are not excluded with Apixaban. Anyway, he says it's just a case of stopping the warfarin one day and taking Apixaban the next but I'm wondering if anyone out there who has made this transition has any good advice/tips to help ease the way? And has anyone ever gone back to Warfarin after trying Apixaban? Thanks in advance...

[10gingercats]

I moved from Warfarin to Apixaban more or less in the way your GP suggests. I think he suggested missing 3 doses of Warfarin and then beg. the Apixaban. No problems.I had been on Warfarin 5 years and was/ am much more vegetarian than carnivore........plus the desire to eat a lot of green veg. and salads.

[Chris1945 in reply to 10gingercats]

Thanks, that's good to know. and reassuring. Doc never mentioned anything about missing 3 doses, I got the impression that as soon as I had Apixaban in my hand I started from that day, nothing about missing Warfarin for a couple of doses....🙄

[10gingercats in reply to Chris1945]

Lost my e mail so here we go again!GP's may vary re how much time to leave between stopping Warfarin and begin. Apixaban.This is what my GP suggested and it was ok for me. perhaps wait and see what others say here.I for one would like to see any official advice on this re. changeovers. It also affects surgery in hospital as in they vary a lot in when to stop your anticoagulant before surgery.

[BobD Volunteer in reply to Chris1945]

It takes three to four days for your INR to return to 1 when you stop warfarin. . Apixaban works on a different part of the clotting process.

[BobD Volunteer]

No food is excluded with warfarin. You just need to balance your dose against your diet.

[Chris1945 in reply to BobD]

I know you're right Bob, do you use a Coagucheck?

[Luludean in reply to BobD]

I thought broccoli , chickpeas and cranberries were not advisable when on Warfarin?

[BobD Volunteer in reply to Luludean]

So long as your diet is consistant you can eat what you like. It is occasional binging which is the problem. If for example you eat vit k rich foods every day then your warfarin dose may have to rise to bring your INR back in line. The amount you take is of no importance so long as INR is within range. I know people who take Vit K supplements to rase their daily level in order that any dietary changes are percentage wise reduced.

[Nan1]

I changed from Warfarin to Apixiban three weeks ago. I had to have a blood test on the Wednesday (reading was 2.6) and told to miss Warfarin that night then start the Apixiban Thursday evening. Change has been ok apart from some joint pain In knees and ankles. Don’t know if that is due to the change. Good luck when you change.

[Hidden]

Wise move no monitoring and apixaban is safer and I believe out performs warfarin, it more expensive for the NHS I think, but we pay enough in tax so in my opinion we are fully entitled to it

Andy

[Dodie117]

I was told to get INR below 2 and then start on Apixaban. I was self monitoring so it only took a day or two of no warfarin.

[MarkS]

It's a shame you want to leave warfarin when you've been on it so long. Eating more greens is a good idea, but that can be done on warfarin. The answer is to get a Coaguchek and monitor your own INR and adjust the dose correspondingly. A well controlled INR with warfarin is superior to the DOACs, all the trials of which were compared to poorly controlled warfarin (I wonder why??).

[Chris1945 in reply to MarkS]

Just checked the price of one...not cheap! But then maybe I'm worth it!

[MarkS in reply to Chris1945]

It's the best £299 I've spent!

[Chris1945 in reply to MarkS]

Your absolutely right and if I decide to stay on warfarin I’ll definitely look into getting one... in the meantime, hope you and everyone else on this forum stays safe...😊

[cuore in reply to Chris1945]

If you decide to switch, you may want to look at this site:

rpharms.com/Portals/0/RPS%2...

The position of the American College of Cardiology prefers NOACs in their Jan. 28/'19 report:

rpharms.com/Portals/0/RPS%2...

[irene75359]

On warfarin, consistency is key; eat as many green veg as you want, just do it every day.