I am on pradaxa and have been on it for four weeks now since founding out I have A F. Does this drug have an anti-dote

[doubtingdolly]

My doctor said if I have a serious bleed or injury they may niot be able to stop the bleed or it could be rather unpleasant

[Hidden]

Dear Doubtingdolly. Not in the same way that a shot of vitamin K reverses the action of Warfarin but Pradaxa, like some other new oral anticoagulants has a much shorter "half-life" than Warfarin and its effectiveness disappears quite quickly; like in a matter of hours not days. That is why in most cases they must be taken twice per day not once like Warfarin.

In most conceivable circumstances, such as a bad cut in an accident say, the normal procedure of pressure on the wound and blood transfusions would work fine until the effects of Pradaxa have diminished but your doctor is correct that there is not yet an instant "antidote". It is a matter of judgement for you if the relative safety of Pradaxa and the absence of need for regular blood testing and dietary control is more beneficial than this potential hazard. My guess is that before too long there will be reversing medications for the new oral anticoagulants available.

All the best with your debate with yourself but do let us know how you decide as many others face the same issue.

[doubtingdolly]

Many thanks PBirt for speedy reply as this has been upper-most on my mind as I did not like the idea of warfarin. Lets hope theres no need for antidote and that they soon come-up with a reversing medication as I am sure more and more people will opt for the new oral anticoagulants.

[jokelly]

Your doctor doesn't want to pay for Pradaxa which costs the NHS about £3 per day, whereas Warfarin is pennies. I have said in another reply, weigh up the risks and make a choice as to the quality of life. I am on Pradaxa and have just had several hospital procedures which involved bleeding. There were no problems and I noticed no difference in blood clotting and healing. Nothing would persuade me back on Warfarin.

[darksteele]

Also be aware that Vit K dose not immediately reverse warfarin and is not really an antidote. It takes around 7-8 hours to be effective, not great if you are suffering a major bleed! It is useful if you have a high INR and need to reduce it and your RISK of bleeding.

PBirt is correct that hospitals know how to manage bleeding whether you are on or off an anticoagulant with physical measures like pressure, units of blood or plasma. Also they have a drug called PCC which is a mixture of clotting factors that helps to switch off the effects of warfarin and the newer drugs like rivaroxaban for example. However the best antidote to bleeding is to stop taking the drug as it is out of your system within a day unlike warfarin which will take 3-5 days. Intact their half lives are pretty similar to the length of time it times Vit K to become effective! In the clinical trials all new drugs were shown to have less bleeding than warfarin without having an antidote.

[feorais in reply to darksteele]

Please do not forget to look at the benefits of Apixaban. In studies it was suggested that of the 3 new ones, this is the one which is least likely to cause bleeding problems. As someone who had to have MAJOR surgery due to the side effects of Warfarin (Maleana) necessitating 32 pts. of blood and plasma over 20 years ago, I wouldn't touch it with a barge pole, and, yes, I had the INR checked religiously every fortnight and it showd no problems.My initial problem was A.F. which is still there , only much worse. I have asked for the Maze Procedure or a Pacemaker but they will not give it to me. I am otherwise fit and capable. I am attending a "centre of excellence" i.e. the Mater Private in Dublin, where one would think they would be able to help, but it has been very unsatisfactory. I would appreciate any help / advice / other if anybody would care to reply?