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Returning to Warfarin after 4 months on Edoxaban

BenHall1 profile image
48 Replies

I am planning to return to Warfarin after 4 months on Eboxaban....... its along story ...... so, back to the beginning.

In mid November 2023 I tripped over our cat ( she is quite okay by the way ), thrust out my left arm and tore the left shoulder rotator cuff tendon from the rotator cuff. As far as I can tell this has now healed. However, in Sept 2018 I had also been diagnosed with osteoarthritis in that shoulder. The pain from this affected joint is worsening by the week ( or so it seems ).

In Nov 2023 to deal with the shoulder pain my GP prescribed Amitriptyline which gave me diahorrea, so that went in the bin, then she prescribed Gabapentin ...... same side effects, same bin. She claimed that on these drugs I'd need to move off Warfarin and take Edoxaban, so, who was I to argue, apart from which the pain was OTT ! and I've done anything.

So she had her wicked way with me at last ... she had been trying to get me off Warfarin for a few years now and I'd been refusing to shift.

My sugery pharmacist is now reviewing my drugs ( and is taking her time ). When I was previously on Warfarin I had my own Coaguchek testing device and I always self tested. ( on occasions I also adjusted my own doses ). I am now planning to return to Warfarin, I have my device, in date test strips and in date Warfarin tablets ----- regardless of the wishes of my GP.

A bit convuluted I know but if you give me an opinion you need my background ........... so .... has anyone ever moved back to Warfarin having ditched Edoxaban ........ and what were your experiences. Of course as my shoulder pain is still increasing I plan to move onto other areas of pain relief, gels etc, so testing my own INR is critical to the success of this. ( not forgetting my own well being ).

John

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BobD profile image
BobDVolunteer

As one who still takes warfarin I see no reason why you shouldn't but will watch with interest.

BenHall1 profile image
BenHall1 in reply to BobD

Thanks Bob .... watch this space. 😱😱😂😂

I don't see why not either and will seek advice. I'm also gonna try and find another INR Clinic in the area ... it may come to that. My lot are obsessed with these DOAC's. Mind you there are many patients with heart implants of varying types ( valvular stuff ) can only take Warfarin.

jeanjeannie50 profile image
jeanjeannie50

Hi John

I'll be very interested to hear how you get on when going back to taking Warfarin. I have chosen to stay on it as that anticoagulant causes me no problems and I'm happy that it has been around for about 60 years.

Jean

BenHall1 profile image
BenHall1 in reply to jeanjeannie50

I'll keep you guys posted. Do you self test for your INR or do you drop into your surgery/ INR Clinic?

John

jeanjeannie50 profile image
jeanjeannie50 in reply to BenHall1

Self test.

Jalia profile image
Jalia

I'm still on warfarin and self test. I'm always being asked at the hospital why I'm not on DOACs. My reply along the line of " if it ain't broke why fix it".Last time I mentioned it to my EP he agreed.

BenHall1 profile image
BenHall1 in reply to Jalia

Hi Jalia,

In the years between Jan 2010 and Nov 2023 I had always been on Warfarin. In more recent years since these new DOAC's have come onto the market and seem to be prescribed by GP's at every opportunity my GP has tried to get me to switch, I have always refused.

In mid Nov 2023 ( when I tripped over the cat ) I ended up with the most violent pain from my left shoulder. It turned out I had detatched my tendon from the rotator cuff. My GP presecribed me Amitriptyline which gave me diahorrea, so that went in the bin, then she prescribed Gabapentin ...... same side effects, into the same bin. Now this is the rub, she claimed because I was on these drugs I needed to get off Warfarin and onto Edoxaban ( her choice ) for best effect. I did her bidding ! So she had her wicked way in the end.

Since I have changed these drugs I've been plagued with immense tiredness and horrormares/nightmares ( as distinct from dreams ) often vile ! I'm so fed up with my godforsaken surgery. I've explained all this to my surgery pharmacist and she has said we'll look at my medication. So for now I am off Atorvastatin pending full range blood tests next Wednesday. Then we'll move to the next one which will probably be Nebivolol, then Edoxaban .......... I don't know what pull Big Pharma have on bog standard companies who run surgeries such as mine ..... but it has to be financial. Cross my palm with ?????? !!

I have now decided as I self test to stop Edoxaban of my own accord and am now going to order my next lot of Coaguchek Test Strips direct from Roche. Then I'll keep my own meticulous records and self diagnose and self dose. There are scientific algorithms online which I have found which enable me to calculate my doseage of Warfarin.

So tonight will be another night of horrormares.

Sorry, just re read this ---------------- sorry for the rant, didn't mean to.

John

Jalia profile image
Jalia in reply to BenHall1

That's OK John! I understand your frustration. How will you obtain further supplies of Warfarin?

BenHall1 profile image
BenHall1 in reply to Jalia

Hi Jalia

I have 84 tablets of 3mg and 56 tablets of 1mg left over from late last year when I was switched to Edoxaban. They are all within expiry date date ... the 3 mg have expiry dates of Oct 2025 and May 2026. The 1mg have expiry dates of March 2026.

So, to answer your question, these quantities give me enough to get restarted and be able to provide my surgery with hard copy evidence that Warfarin is better for me than Edoxaban.

My previous dose was on alternate days 4mg and 5 mg or 31/32 mg a week. From that point on I will expect my earlier prescriptions to be reinstated. Why is it that these days it is always a battle with surgeries - even to hold a sensible conversation ? 😂😂

John

jeanjeannie50 profile image
jeanjeannie50 in reply to BenHall1

John, I'd be far better off deciding my own dosage of Warfarin for myself if my INR is low or high. Not something that needs a great calculation is it. If it's low add a little more, high then reduce dose a little. I don't need a machine to calculate that for me. I thought you used to do that too?

Jean

BenHall1 profile image
BenHall1 in reply to jeanjeannie50

Jean, the machine I use ( Coaguchek XS ) is for determining the INR, apart from that I do the same as you for determining the dose. Back in the day before I was switched to Edoxaban I always self tested to get my own INR on my own machine, then I would phone in the result and the INR Clinic would log it and give me a new dose and a new test date. It was all so very simple. Then my wretched GP got involved and started meddling. 😭😭

sunlovah profile image
sunlovah in reply to BenHall1

Curious...have you tried other DOACS? If you did, did you have any side effects with them?

BenHall1 profile image
BenHall1 in reply to sunlovah

Of all the 4 DOAC's it was my GP who elected/chose Edoxaban, not me - no doubt she felt this was best. I do not trust Big Pharma and their products and in any case I had no problem with Warfarin .... there is no doubt Big Pharma are trying to force Warfarin out of the marketplace, except they never ever will at this point in time because many people with certain types of heart conditions can only use Warfarin.

At the moment Edoxaban is giving me problems, its just that my surgery won't listen to my comments as a patient. No, I do not want this new stuff, it is too young, as are many GP's and therein lies another problem in my surgery. I guess they are all trained in 'new is best - ignore the patient ' !! Warfarin is at least 60, maybe closer to 70 years old. Tried and proven.

sunlovah profile image
sunlovah in reply to BenHall1

I agree, being sick is profitable and big Business for 'Big Pharma'.

Edoxaban (made me feel unwell) is being blanket prescribed by GP's as it's the cheapest, plus less time/ money spent on Warfarin testing. There are others to try Apixaban/ Rivaroxaban etc . You have a right (if you wish) to ask to try another, although, I understand you wishing to stick with what's tried and tested. Be interesting to hear how you get on.

BenHall1 profile image
BenHall1 in reply to sunlovah

Hi sunlovah,

Thanks for that. Yes, I understand the other options to Edoxaban but I'd be happier staying with my good friend Warfarin - particularly as I have all the INR testing equipment at home. On this, my surgery has shedloads of nursing staff and the senior nurse also runs the INR Clinic, so the additional costs that I may inflict on the surgery are minimal, a phone call for me to phone in my INR and a return phone call from the INR Clinic telling me results, new dose and new test date. Sorted.

There have been many on here over the years who have publicly derided Warfarin, more I suspect a reflection of the way Warfarin behaves and testing opportunities that are commonplace and their absolute lack of understanding of the whole process!

The other problem I have is with me - I am an oddity - I'm 79, an old git, I work part time driving a double decker bus of students for a major national bus company for a contract they hold. I only work in College Term time. My point is that at my surgery some damn clerk opens their computer, resurrects my file, sees my age and lumps me into the the category of ALL 75 to 80 year olds. As my employer is a major player in the UK bus industry they arrange my annual medicals which are sent to DVLA who reissue my driving licence each year ( so long as I pass the medical ). This information is not automatically available to my GP without my approval. I can probably drive a double decker bus in situations that would defy most 50 year olds in a Mini.

I have blood tests mid week next week ..... be interesting. I'll post comments when they become available.

sunlovah profile image
sunlovah in reply to BenHall1

I understand exactly what You're saying, the system tends to operate on a 'one size fits all' basis. Hope all works out for you, good luck

Mrsvemb profile image
Mrsvemb in reply to BenHall1

BenHall1 no doubt your GP thought Edoxaban was the best because it is the cheapest DOAC. A lot on this forum have reported that they have been changed from other DOAC’s to Edoxaban because its cheaper. Stick to your guns John. You know what suits you best. Val

BenHall1 profile image
BenHall1 in reply to Mrsvemb

Thanks Val, I certainly will .... notwithstanding all its disadvantages Warfarin is for me. I shall keep records of my data on my return to Warfarin and hand it in to the INR clinic once I'm back on Warfarin and stable.

John

Auriculaire profile image
Auriculaire in reply to BenHall1

Hi John - it might be that the switch to Edoxaban has exacerbated your pain or at least hampered recovery. I find Apixaban does that for me. I think it unlikely that the change from Bisoprolol to Nebivolol has given the bad dreams. Beta blockers have a reputation for that anyway and there is probably not much difference between individual ones. If you are no longer getting afib attacks ( though you need to check that you are not getting asymptomatic ones with some monitoring device ) do you need a beta blocker at all?

BenHall1 profile image
BenHall1 in reply to Auriculaire

Thank you Auriculaire ..... as time is moving on I think I have to agree with you. Playing the blame game I am thinking that much more is attributed to the Edoxaban - I'm so convinced that I have already started the gradual phasing out of Edoxaban and a return to Warfarin hopefully into my INR range in a few days and then stay there. Not a problem for me based on my past experience between 2010 and 2023. Hopefully too it will help return me to the 'old and lively me'.

Further down the track I'm looking at just that ... off beta blockers altogether. Yes I shall have a look at some sort of appropriate monitoring device just to cover that asymptomatic AF event possibility.

Threecats profile image
Threecats

Hi John

Funnily enough, I came across a trial a couple of days ago that showed fail elderly patients (elderly classed as 75 or above) who were switched from Wafarin to a DOAC had far more episodes of bleeding on the DOAC, so much so, in fact, that they stopped the trial. Obviously you don’t fall into the “frail” category but it’s food for thought, isn’t it.

Good luck with your switch back to Wafarin.

TC

BenHall1 profile image
BenHall1 in reply to Threecats

Hi TC ......... and good morning to Wild Child 🐱,

Thanks for that. Well, I have just started my switch back to Warfarin so your post is very timely. I became aware of these DOAC's way back around 2012 and looked at the development of them. At the time I wasn't impressed particularly as some elderly folk in Australia in 2013 died following taking Dabigitran. I formed the impression there was an indecent haste by Big Pharma to push this new stuff into the marketplace. I was turned off at the time and with my experience with Edoxaban I'm even more so. I also wonder if and how Big Pharma help healthcare practioners to improve their skill set in moving from Warfarin to DOAC's ? I suspect only minimal ( and that is being generous ).

True, I'm not frail...... but I am in a risk group ... being a part time double deck bus driver and always at risk of internal (or any) injuries arising from a (MTA) motor traffic accident. My point is that if I were in a MTA on Warfarin I feel that if I were attended by paramedics they would more easily, and readily be able to apply reversal agents to me with the knowledge of Warfarin and how it behaves - than if my card said Edoxaban.

So now I have dusted down my coaguchek testing device and test strips and away we go and although NHS do not state that I need to have a loading dose of Warfarin, my initial INR suggests otherwise. Frankly, none of this worries me as when I was on Warfarin I had to stop and restart Warfarin on 4 seperate occasions for 4 different medical proceedures, the most challenging being a knee replacement. No problems whatsoever. All that said , I accept many folk couldn't/can't handle Warfarin and these new DOAC's are a blessing. But also, these is a lot of ill informed contrived info floating about re Warfarin.

Have a nice day.

John

Threecats profile image
Threecats in reply to BenHall1

I quite agree with all that you’ve said John. I’m not on ACs yet, due to age, despite persistent (permanent?) AF but, when the time comes, I would prefer to go on Warfarin and do my own checking. I know I’m a control freak but I personally prefer to know what my levels are, rather than just taking a “one size fits all” DOAC. We all respond differently to drugs, in my view and I would prefer to take something where I can measure the effect it’s having on me and adjust the dose accordingly.

Good luck to you in your switch.

All the best TC. The Wild One sends her regards too😸

BenHall1 profile image
BenHall1 in reply to Threecats

Hi TC, good morning Wild One 🐱,

I do not have a healthy relationship with my surgery, we tolerate each other and that's it. I suppose I too am a bit of a control freak, certainly I am a challenge to the universe ( ask Mrs BenHall1 ) BUT it is so important to take control of your own destiny and I found the control over my life that Warfarin provided was brilliant ...and more importantly if you follow Warfarin rules with food it gives a bonus to your healthcare. Your approach is one I share and is the way to go. With Warfarin of course, once you understand its behaviour you have two options you can either adjust the dose, or vary the food - important. Sometimes I found adjusting/varying my food was simpler than adjusting the dose to produce any given INR.

Incidently, during this switchover which is now under way, where I've had to make a blood draw from a finger I found that with neat blood from pure Edoxaban it almost gushed out of the puncture. Now I'm more into Warfarin that same blood draw is more gradually emerging from the puncture ( in a different location ). This to me suggests that if a person is on pure Edoxaban and is involved in an accident ( say motoring ) then blood loss maybe be quite dramatic, both externally and who knows what happens with an internal bleed. From this I see Warfarin giving a much slower bleed rate (but none the less still a blood loss ).

Have a good day.

John

Threecats profile image
Threecats in reply to BenHall1

It’s interesting what you say about the noticeable difference in bleeding rate when doing your finger prick testing. I wonder if that’s due to the different modes of action of the two drugs. Whatever the cause, I do agree with you that, based on that evidence, it would make one wonder what would happen in the event of an accident involving blood loss.

I completely agree with your points about Wafarin. All I’ll have to attempt to do, when the time comes, is try and convince my GP to prescribe it. Therein lies the challenge!

All the best TC and WC

BenHall1 profile image
BenHall1 in reply to Threecats

Mornin' TC and WC,

Re the difference in bleeding rate ..... yes I am sure it is due to - not just the different modes but different ingredients. I see it this way, each of these new DOAC's are different among themselves and from Warfarin, which makes them attractive to many patients who have an adverse reaction to any of the others. My concern is that GP's, willy nilly prescribe whatever they feel like, or whoever gives them the biggest kick back ! Inevitably, unless a patient has a health condition which restricts them to Warfarin, Warfarin now will not be prescribed.

I have to say I was quite surprised at the rate of bleeding with Edoxaban, alarmed in fact. Anyway, so far, my Warfarin consumption is jogging along well, my INR is coming up to the required level.

As a matter of interest there is a pharmaceutical YELLOW CARD system in place and I have used this to file a formal complaint about Edoxaban and its side effects. It can be found at the end of the leaflet in a medication packet as well as online.

When the time comes for you take Warfarin, take Wild Child into the fray and frighten your GP to pieces. 😂😂😂

John

Threecats profile image
Threecats in reply to BenHall1

Now there’s a thought, John. I could employ my secret weapon 😂 The Wild One does an excellent job when it comes to an icy stare and will often accompany it with a lip curl for good measure 🙀 That doctor would be putty in my hands🤣🤣🤣

Glad to hear the Wafarin reintroduction is going well👍

TC & WC

Cavalierrubie profile image
Cavalierrubie

l can’t tolerate any of the DOAC’s and take Warfarin. I think you have the right to decide what you put in your body - you are the only one who knows how it works and how you feel. A couple or so Doctors l have seen, since l have been on this journey, have highly praised Warfarin. It annoys me when greed is put before the patient. Let us know how you get on. It must be very stressful for you, but keep firm.

BenHall1 profile image
BenHall1 in reply to Cavalierrubie

Thank you Cavalierrubie, it is comforting because using my Virgo logic I have to argue ... well if Warfarin is no good - how come Big Pharma have taken 70 years to provide other anticoagulant options ?? The other point is that my surgery has or seems to have amongst its GP staff a culture of youth who seem to disregard the experience of older generations, and in many cases their wisdom.

John

Cavalierrubie profile image
Cavalierrubie in reply to BenHall1

I absolutely agree with you John. In many aspects of everyday life, decisions are made by the younger generation and their decisions based on theory rather than practicality. Our District Council for one, employs students straight from university who have no practical experience and have caused many blunders. Unfortunately, this is the way life has become. If you are over 70 you no longer have a brain! Numerous times l have been told by my GP “It’s probably just old age,” making you feel as if you are wasting their time.

Regarding Warfarin, l have been told by two hospital doctors, and a paramedic that Warfarin is the best and better dealt by them. Time will tell on that one. Take care and hope you get stabilised soon.

PICCASO profile image
PICCASO

I went back to warfarin after my cardiologist recommended Riveroxaban , it gave me Muscles spasms, I just saw my INR nurse told her and she put me back on warfarin, it's one of the side effects Rivereroxaban I looked it up ,

secondtry profile image
secondtry

Well thank you John for this post, very timely for me.

Last Wednesday my cardiologist after 11 years finally won the battle to put me on anticoags and prescribed Edoxaban 60mgs. I don't like the sounds of your findings of tiredness and nightmares; my brother also recently started Edoxaban and he reports weirder dreams.

I agree with your sentiments on DOACS but unlike you did not have the prior experience of Warfarin and don't know what's required to test at home. The cardiologist dismissed it by saying you don't want to be unprotected because one day you munch through a lot of greens (he knows I am on a very healthy diet). I didn't feel in a position to counter that argument.

I am equally concerned as others that DOACS are prescribed for economic/commercial reasons first when that should be patient first. Also I believe there is too much misplaced trust in Big Pharma. So I may be joining you in switching after a trial period.

Best wishes.

Cavalierrubie profile image
Cavalierrubie in reply to secondtry

I eat everything in moderation. I adjust Warfarin to what l eat, and not adjust what l eat to obtain the correct INR. Consistency is the key to maintain a correct reading. My ratio, which l believe is normal for AF patients, is between 2/3 which gives you lots of room for adjustment. Best wishes.

BenHall1 profile image
BenHall1 in reply to Cavalierrubie

Hi again ... me back ! I totally agree with what you've written, well said .... exactly, exactly how I was in those 12 years or so on Warfarin. Consistency, consistency and even more consistency ........ job done ......... sorted. My initial agreed INR was between 2.0 and 3.0 with a precise target of 2.5 ........ on balance over the years my INR fell between 2.2 and 2.7.

John

ozziebob profile image
ozziebob in reply to secondtry

While the adverse effects of various DOACs will rightly lead to a change for some, many on the Forum have reported positive experience with edoxaban, so perhaps we need to be careful not to indulge in an "all-too-easy" general condemnation of edoxaban. This general condemnation particularly arose at the time of the "switching" to edoxaban as the first choice anticoagulant in many NHS Health Trusts.

It's worth keeping in mind this German research that showed edoxaban had lower stroke risks than all other DOACs and Warfarin, and equal lowest major bleed risks (with apixaban). The conclusions of the study are a quick read ...

pubmed.ncbi.nlm.nih.gov/347...

One initial "amateur" reservation about this research is that perhaps the Warfarin cohort might have been older than the DOAC cohorts because of the history of anticoagulation prescribing?

As most will probably agree, the research into the relative safety profiles of DOACs and Warfarin can be a confusing minefield of comparative claims to anyone who wants to decide for themselves the best way ahead. But the research goes on, and as patients we must take note.

BenHall1 profile image
BenHall1 in reply to ozziebob

I must agree that the outline you've given fits the mould of 'universal' thinking. I'm pointing my issues directly at GP level who seem to be executing the will of collective Big Pharma with a complete disregard of the needs of individuals and unfortunately age enters into the discussion .... obviously kick backs are the only conclusion I can arrive at. Money talks, sometimes only gibberish.

My discussion of Edoxaban v Warfarin have all be based on my experiences and it would seem that many share to some degree or another my experience. Some do not. For my money they have been introduced far too quickly, getting approval from various nations health administrations has been a 'routine', a legal process easily fulfilled by Big Pharma ........... the issues at user level are only just emerging and will probably continue to emerge over the next few years.

Threecats profile image
Threecats in reply to ozziebob

Another reservation regarding the study that might be worth noting is that the majority of the authors appear to be linked, either directly or indirectly, to the company that developed and brought Edoxaban to market, Daiichi Sankyo.

BenHall1 profile image
BenHall1 in reply to Threecats

Oh my goodness TC, that's like asking the cops to investigate themselves ! 😂😂😂😂😂😂😂😂

ozziebob profile image
ozziebob in reply to Threecats

Yes, I remembered your previous warning about this, and had looked again at the article before writing my Reply, but again quickly got lost in the list of authors, frustrated I couldn't easily find the conflicts of interests you mentioned, so in my haste, left it out of my Reply. At least it was a "retrospective cohort study" of 3.5 million patients, which I hope has a lower risk of being "manipulated", but perhaps that's naive.

I will be looking forward to your future warnings about research authors and conflicts of interests, and not just those relating to edoxaban. You are obviously better at "sniffing them out" than me.

BenHall1 profile image
BenHall1 in reply to secondtry

Hi secondtry,

Edoxaban, my GP had been trying to get me off Warfarin onto one of these DOAC's for a few years. I've kept on refusing. I'm now aware that I've now been conned ! Following a domestic fall which resulted in my tearing a tendon in the left shoulder rotator cuff and copping a whole new dimension of pain. My GP said she'd prescribe Amitriptyline but these gave me unpleasant side effects from my gut, she then tried Gabapentin .... that gave me the same side effects. I wrote to her and said no more experimenting, I'll stay with CoCodomol 30/500. She claimed these two drugs worked best with Edoxaban, not Warfarin. I fell for it. I'd been on Edoxaban for 4 months and this immense tiredness ( and moodiness ) and nightmares ( horrormares which made a Vincent Price horror movie look like a Mickey Mouse cartoon ) just got worse and worse.

I'm now into the third day of my switch back to Warfarin and my INR is coming along nicely. As I'm well experienced with Warfarin I don't need to have any consultation with my surgery - I'm just doing it and will tell them ( in writing ) on Wednesday when I go for non related blood tests. So much for the GP's mantra ......... "do no harm" !

Many folk and healthcare professionals take great pleasure in deriding Warfarin. Sure as with all drugs there are some who get side effects and so these DOAC's are a blessing. By and large though Warfarin is just fine ......... and if you can conduct your own INR testing in your home setting ( or even in a holiday setting ) - I have taken my kit all over the place, even on holiday in Sydney and outback Australia ........ there are few limits ( if any at all ) The naysayers are just involving themselves in mischief making.

The key of course is to do your own testing, I bought my own Coaguchek device and surgery provides me with test strips on prescription ... no sweat! The naysayers do not ever liken it to what a diabetic does when testing their blood sugar levels. Its a small finger prick test, a drop of blood emerges, drips onto the test strip and the device gives a reading - known as an INR reading. I phone or email surgery, they feed it into their Coaguchek software and tell me my next dose and next test date. Sorted. Testing is usually to start with every week or two weeks , I ended up on 10 week testing.

All the time I was on Warfarin I never made any concessions to food or alcohol but whatever I did was both in moderation and consistent. The one thing Warfarin loves is consistency, consistency and even more consistency.

So secondtry, if I can help you further in your arguments with your healthcare providors I'm happy to do so, just PM me and I'll reply with some independant reference material along with more of my own experiences. Incidently, I've had to stop and restart Warfarin on 4 occasions for medical procedures over the years. There isn't a problem as long as the protocols are followed.

Good luck,

John

secondtry profile image
secondtry in reply to BenHall1

Thanks John, very informative and a great offer to PM you. I know what you mean about GP surgery struggles meaning we all have to adapt to combat it 🤔.

richard_jw profile image
richard_jw

Not quite the same, but I was initially put on Rivaroxaban. After a month, it caused my IBS symptoms to worsen. They switched to Apixaban, but it did not help.

So I decided to try Warfarin, because it works differently to a DOAC, and might help.

The doctor could not get the INR value right, but after 2 months of trying, my IBS was no better, and I possibly suffered a TIA. The A&E doctor put me on Edoxaban rather than Warfarin.

So I have gone from a DOAC to Warfarin, and back to a DOAC.

I cannot say that I suffered any ill effects as a result of this switching.

BTW the possible TIA was something else. I have worn a Holter for several weeks (a week at a time) and no Afib has been found. So the suggestion is to come off anticoagulation

BenHall1 profile image
BenHall1 in reply to richard_jw

Gosh, that sounds terrible. It would seem maybe that the problem child in the context of Warfarin was/is your IBS. I have learned over the years the last person I'd trust to advise on Warfarin is a family Dr ( a GP ). An INR clinic, with a properly qualified INR nurse is a much better option.

Wishing you well off the anticoagulation in the future.

Falcon9 profile image
Falcon9

Hello Ben, I'm on Apixaban ( 4.5 weeks) for a DVT and after experiencing no problems for 3 weeks, I now find that I have a very itchy rash mainly on my upper chest and shoulders. I've had 2 previous DVTs and had Warfarin both times and without a problem. I'm waiting a few more days to see if the rash improves ( I've had a chesty cold for 10 days so maybe the rash is viral)and then will go and discuss if it's Apixaban that's the cause. I'm wondering if switching is easy, i.e. stop Apixaban and use warfarin or if it's more involved due to the monitoring needed for Warfarin? My memory is vague but 12 years ago when I had my 2nd DVT all I can remember is getting the INR level correct and then going for a test ( finger prick) once a month. I was on it for about 6 months, now, whichever it is, I'll be on for life.

BenHall1 profile image
BenHall1 in reply to Falcon9

From my readings ( of bits of paper in the packet ) and on the NHS website of medications I seem to recall that a rash is related to the new DOAC's of which Apixaban is one. It could be a common denominator of all 4 DOAC's.

In terms of Warfarin I bought my own Coaguchek handheld testing device and my surgery provided the test strips on prescription. My Surgery had the INR Clinic which gave me all the support and I've never looked back. Basically, take a finger prick drop of blood. Make sure the test strip is in the device, drop the blood on the test strip and wait for the reading. Phone the reading to my INR Clinic they will process it through their computer using their own Coaguchek Software and it will produce a new dose ( which maybe even the same dose ) and the next test date. I have an agreement with my INR clinic that we do a joint reading every 10 weeks to ensure my device is still accurately calibrated and not giving a distorted or incorrect result. In other words, one finger prick drop of blood on my device and the surgery device at the same time and check the results. My device was never more than 0.1 or 0.2 difference between the two devices.

My test date intervals varied from two weekly to 4 weekly up to 10 weekly.

Simples !

Falcon9 profile image
Falcon9 in reply to BenHall1

Thanks for the info Be. All the best.

Thomas45 profile image
Thomas45

When I was first put on Warfarin my INR wouldn't stabilise. I wasn't eating regular meals. So I was transferred to Rivaroxaban. No one told me to take it with a fatty meal. I then, and now, don't eat fatty meals.Within hours of taking Rivaroxaban I had excruciating pains throughout my body, thankfully not in my head. I rang the GP after 3 days and was told my body would get used to the drug. It didn't. On the evening of the 12th day of taking Rivaroxaban, I decided I wouldn't take any more. I managed to get an appointment to see a GP on the 13th day. It was in a neighbouring village. When I entered the waiting Room another patient remarked that I looked unwell. I needed a stick to walk,

The doctor said that he didn't realise I was so bad. After the usual checks I was sent for blood tests, with co-codamol tablet prescribed for the pain. They were of little use.

I bought a Coaguchek meter and went back to Warfarin. My INR soon stabilised.

I was given blood tests every week to investigate the pain. On the 5th week a doctor rang up, saying that "we think we know what it is", but I needed another blood test. This was for Erythrocyte Sedimentation Rate, which indicates how inflamed my body was. I should have had a rate of about 20, anything above showed inflammation. My rate was 130, that, the stiffening up I suffered 30 minutes after getting out of bed, and the other tests I'd had confirmed I had an auto-immune condition called Polymyalgia Rheumatica . The only treatment is a very slowly reducing dose of prednisolone. It took me just under 4 years to get down to no tablets.

The doctors considered it was caused by my body rejecting Rivaroxaban.

A year ago my arrhythmia nurse left and the first thing the new nurse said was that I ought to be on a DOAC. I explained my problems with Rivaroxaban. I was happy with Warfarin. She told me that there were 4 different DOACs and that they were not all the same. I said I knew they were not all the same, because they had 4 different names, but told her it was a case of Once bitten, twice shy.

I'm happy on Warfarin. I self test, and email the results.

BenHall1 profile image
BenHall1

Wow! Thomas 45 ............ what a story.

Your experience with your new arrythmia nurse gave me a chuckle ( not at all funny to you at the time I'm sure ). I have to make the assumtion that you experience much as I do that your nurse is probably about 40 years younger than you. Funny how they always think they know best ........... sometimes I think of pointing out to them that in the field of medicine ......"youth is wasted on the young". Luckily our Senior nurse is probably early 50's and she is also the main INR nurse and she is great, often with little gems of useful advice. I'm hoping she is on duty when I go for full range blood tests on Wednesday this week.

I agree, with Warfarin, self testing is the way to go - after all it isn't that much different to what a diabetic does in testing their blood sugar - not rocket science.

Thank you.

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