I was using Flacinide for treating my a fibs as a pill in the pocket. (10 years) Then I caught diabetes and had something happened that made the Flacinide not work to end afib attacks. Now doctors want me on blood thinners. They chose Metropolol for helping with a fibs but not sure what is choice for blood thinner
Is there a better choice?
All anticoagulants work. Some are more convenient than others, warfarin for example being probably the cheapest (and since it has been used since late forties well understood) does need your blood to be tested and it can, for some people, be difficult to keep in correct range. I've been on it nearly twenty years with zero issues and stay well in range.
The more modern drugs, the DOACS or used to be called NOACS are more expensive and some people complain of problems resulting from their use but since there are four of them one should be able to find one that suits you if you reject the idea of warfarin.
There is a useful booklet on our main website (Atrial Fibrillation Association) explaining anticoagulants that you may find useful.
I see you're from the United States as I am. Here, unless you have a speccial reason, NOAC's are almost always prescribed for atrial fibrillation vs the older Warafin.
I started with xarelto which offered the convenience of once a day dosing, but later switch to Eliquis (twice a day dosing ) after a little research that showed it may have a very slight edge in regards to bleed risk. But any of them should work and often it comes down to your insurance coverage.
Jim
The newer anticoagulants are routinely prescribed here in the UK too Jim. Warfarin is only prescribed, think it's if you have a metal valve in your heart. Have been told this today but already forgotten the exact words.
No hope for me! 🤔
Jean
The newer anticoagulants are routinely prescribed here in the UK to Jim.
I assumed that much, but with so much talk about Warfarin here, I wasn't sure. So thanks for pointing that out. From everything I've read, the NOAC's seem to make more sense than Warfarin for most people. Assuming they actually need a thinner, of course.
Jim
Yes, it's only we that have been on Warfarin for many years that tend to stick with them.
I started with Xarelto and then read that Eliquis here that was slightly better, so changed to it, but it gave me terrible heartburn. I changed back to Xarelto, it seems the risk difference is very slight from the papers I read. Xarelto was suddenly introduced in South Africa where I am,under the name iXorolo, it looked exactly the same except for the name on the box, and was half the price. Now, although it still in the same box and is still called iXorolo, it has shot up to previous Xarelto prices and is more expensive than Eliquis . I wonder what sort of marketing games the big Pharmas play !
The best one is the one that suits you. I am on Eliquis (Apixaban) and it suits me really well and I have had no problems in 8 years of taking it. It has not noticeably stopped my blood from clotting as quickly as before when I injure myself either. For example I fell in the kitchen on Tuesday hit my chin on the granite worktop on the way down and broke a few teeth (dentist is laughing all the way to the bank) bleeding stopped within a couple of minutes lots of deep cuts inside and outside lower jaw - one almost right through my cheek - heck it did hurt! Lots of bruises - on my bad shoulder, new knee and new hip - why do you always fall and hit yourself on those places? Had scan in A&E because they were worried the jolt might have caused a bleed I quote: "... the jaw is still the head. There is brain atrophy with aging which stretches the vessels on the surface of the brain. An impactful jolt can tear them." I don't usually go to A&E for these things - have hit my head loads of times in the garden and doing silly DIY stunts and falling but that's when my wife doesn't know about it - easy to keep quiet about it when there is no blood and broken teeth on the kitchen floor LOL. So, she talked me into going to A&E. Don't think I would bother to go again unless I am caught out again ha ha!
You are a dangerous man! You seem a good candidate for wearing a "crash test" helmet during daylight hours, or even longer if you also headbutt lamp posts and regularly fall out of bed.🤕😆
Then again, you seem to bounce back in good humour. Keep safe my dangerous friend.
I am always bashing my shins, so my son bought me a pair of Wellington Boots to wear. ! If he thinks I'm going to pad around the house in boots, in the middle of a South African summer, he must need some special medication !
oh that's funny! Yesterday I went to the OCCM (Old Codgers' Coffee Morning) and someone hit a cup of freshly brewed hot coffee over my legs ! so rushed home - only around the corner and had a cool shower - no damage but not going out today at all! Wife says I have to sit still and sit on my hands 
No damage done but I've not had a good week.
Talk to a high street pharmacist.
Most people seem to be prescribed either apixaban (twice daily) or edoxaban (once daily), it seems these days. Rivaroxaban is another option. If your doctor has done things according to the usual protocol, he or she will have calculated a so-called Chads2 score for you to work out whether you need these tablets yet. My elderly friend takes warfarin (Coumadin) but that is not usually a first choice these days owing to the cost of weekly clotting checks needed.
Steve
As others have said, the best anticoagulant for an individual patient is related to that individuals unique calculated stroke and bleed risks.
I have liked this German research from 2022 which gives comparative results for DOACs and Warfarin. But remember, this is only one study, and I am not offering advice, but it may give you a basis for questions to your medical team.
Comparison of clinical outcomes of edoxaban versus apixaban, dabigatran, rivaroxaban, and vitamin K antagonists in patients with atrial fibrillation in Germany: A real-world cohort study
pubmed.ncbi.nlm.nih.gov/347....
Good luck.
That study favours edoxaban made by Daiichi Sankyo, and guess what? It's paid for and largely written by Daiichi Sankyo!
Hi
Metoprolol is a no when it caused breathless Day and pauses during night. And it did not control my heart rate day of 186.
Bisoprolol is better for Afers my Heart Specialist says and for BP not for H/Rate at 156.
CCB Diltiazem was introduced and immediately within 2 hours my 156 fell to 51 on 1/2 dose.
Now AM Diltiazem 120mg CD for H/Rate now 60s Day. My 47bpm Night stays.
PM Bisoprolol 2.5 for BP for BP control especially Systolic. 110-130. /. 69
110mg PRADAXA x twice day. My anti-co.agulant med.
cherio JOY. 75. (NZ)
Warfarin works well, but as some say it takes repeated constant monitoring to have it work well. I was on it for a year but now take only natural bloood thinners like Nattokinase, Vitamin E and Turmeric. Ben on those for over 9 years with no issues.
My pulse rate control by prescription drugs is Diltiezem 240mg, Metropolol 25mg.
Seem to all work together OK.
Good luck to you.
In the UK, most people over 60 receive free prescription medication (we’ve paid in for 45+ years).
I was prescribed Apixaban x 2 per day, then our NHS negotiated a better price for Edoxaban x 1 per day about a year ago.
Recently I read that the Eliquis patent for Apixaban had expired, it will be interesting to see if other companies produce it at reduced costs.
I refused to change and referred them to my EP,who had prescribed Apixaban. I believe it has now had patent expired. My latest prescription has 2 different manufacturers Sandoz and Axunio pharma.
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