My pharmacy no longer dispense the 5mg warfarin tablet, has anyone been told why this is or the logic behind it?
This decision will cost the NHS more money especially at a time of austerity, to me it just don't make sense but would like to hear other members opinions. I take 5.5mg (2 tablets 1x5mg and 1x0.5mg) but will now be required to take 1x3mg, 2x1mg and 1x0.5mg (4 tablets).
Awhile ago it was nationally discussed about the potential for error between the 5mg (Pink) tablets and the 0.5mg (white) and some discussed the concept that we should stop using the 0.5mg dose.
The need for the 0.5mg dose could be dealt with by either breaking tablets or alternate day dosing (1mg one day, 2mg the next would balance at 1.5mg daily)
I was unaware of anywhere this had been adopted and, of course, it should only be introduced in discussion with the people who take the tablets
Cost is not an issue here, warfarin is an extremely cheep medication, the cost comes through appropriate monitoring
I would ask the local PCT, through the PALS department, if this a local directive
I hope they don't stop the 0.5 tablet. I like many others are very sensitive to dose, at the moment I'm on 2 mg Sun, Mon, Fri, 1mg Tue, Thurs, Sat, and 2.5 on Wednesday, which seems to be keeping me in range. But clinics do not like people breaking tablets so 0.5 is really useful
Hi. 5mg tablets and 0.5mg tablets were withdrawn in Sheffield a few years ago too. The explanation given was that many elderly patients were taking warfarin, some of whom were easily "confused" and taking a large overdose was dangerous. It was considered less likely to accidentally overdose if only 1mg and 3mg tablets were in use. Rather questionable logic but certainly with the best interests of patients in mind so why not support it..
Thank you for your reply and totally agree with the safety of patients but the logic is simple, if some patients are confused by the tablets they should not be taking them without being put into a safe daily/weekly box provided by the pharmacy. The reason I am questioning the logic is why not give these patients the new one tablet anticoagulation. Now I understand that not everyone will be suitable but we must move forward and find new anticoagulants that are safer.
I couldn't agree more but I am sure that the final answer will boil down to the fact that warfarin is much cheaper than the new medications available and this will be a big hurdle to jump in today's economic climate. Never-the-less, we should go for it!
some times the new tablets give problems i have been taking pradaxa twice daily and have to take a further tablet due to stomach problems what is the one a day tablet and is there much history of people taking this one
If it's Omeprazole that you are taking be careful as reduced my red bllod count and I felt exhausted all the time! I had to stop taking it in order to get my red blood count back to normal. An internet search will reveal medical papers identifying the effect. My GP didn't know anything about it.
Hello, have you asked the pharmacist why? Then letters please to PCT, MP and PM!
Yes, and got told it was to do with patient safety. Now I totally agree with patient safety but like I said to PBit, patients who are unable to take their drugs safely should be monitored by their phamarcy with daily/weekly pill boxes. I am in contact with PALS who hopefully will find out where this policy was thought up without consulting patients, if that was the case.
I have no problem getting 5 mg tablets from Boots in Manchester city centre.
Nice one Balach, useful information
I'm taking 7mg/8mg in the form of 1mg tablets on alternate days.
Quite often I am in a place where I can't conveniently find some water to help the swallowing process. Also, I find the tablets so small they are easily dropped between hand and mouth,
Anyway, I asked my GP to prescribe 5mg tablets instead of 1mg. My reasoning was that my daily dose would be 1 x 5mg + 2.5mg (half a 5mg which are easily broken).
Request was refused on the grounds that local and national bodies where all recommending that only 1mg rx be written. This on safety grounds in case the patient gets confused and swallows, say, 8 x 5mg tabs. For most patients I find that a ludicrous and patronising logic; if I only have 5mg and have specifically asked for them so that I can only take 2 tabs instead of 8, then surely I am not going to mistake them for 1mg?!
I will protest this decision next time I see the doctor concerned.
Regards
Will Chapman
Hi Will
Thank you for the information above and totally agree with your logic however, my GP pharmacy does allow me 3mg tablets. Like you I intend to raise this with my GP and like you, I don't see why they can't supply me with 5mg tablets. Like you, I find this very patronising and intend to find out who made this illogical decision
Dear Members
Please see the response from PALS on the 5mg tablet.
Thank you for contacting NHS Cambridgeshire PALS regarding warfarin tablets.
Please see below a response from our medicines management team:
It has recently been highlighted that there is a potential for confusion when prescribing, dispensing and administering warfarin tablets. 5mg may be mistaken for 0.5mg-(sometimes written as 500mcg) on the medication screen or when dispensing. 5mg tablets (pink) and 1mg tablets (brown) have been confused by some patients with impaired vision or colour blindness.
Therefore it has been advised that doses are made up of 1mg (brown) and 3mg (blue) tablets to reduce the risk of error or confusion. Each practice will have their own policies in place in relation to high risk medications, in which I include warfarin, to ensure that their processes reduce the risk of error and protect all patients.
It is of course the discretion of the prescriber (GP), taking in to account their practice policy, how a warfarin dosage is constructed, and the number of tablets this includes.
I would suggested going back to your GP to speak to them about which tablets you are prescribed as they may be able to provide further help.
I hope this information is useful.
Update
Since being refused 5mg warfarin tables, I have discussed my concerns with my GP and he has agreed to supply me the 5mg again, especially while travelling.
I am appalled that they would limit a person to maximum of 3 mg tablets as the highest. I have to take 17 mg per day of warfarin which I know is high, but I have a very high resistence to the drug. Therefore, taking 5 mgs tablets is essential to me so I don't have to take countless numbers of tablets per day. I get them from Kamsans pharmacy. Interestingly, when I was in hospital they didn't do 5 mg tablets, but no one appeared to know why so these postings are really helpful.
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