New Medication

[Katrinam]

Hi all, I've been taken off cleaxane and aspirin and put on to a drug called Dabigatran etxilate 150mg twice daily. I was just wondering if anyone has used this before and what you thought about it.

Thanks

Katrina

[PMRpro]

For anyone else - it's also known as Pradaxa. It is a new generation anticoagulant which (they claim) doesn't need regular blood tests to monitor how you are responding to it as warfarin does.

Clexane is only available as injections - long term use isn't really feasible. Aspirin does something completely different and isn't really as useful as a lot of doctors think! That's why you have been put on Dabigatran - even only a couple of years ago it would have been warfarin but in most healthcare systems these new ones are being used despite their price as it means the patient doesn't need the blood tests which does save some of the cost.

I'm on Pradaxa because I have atrial fibrillation. At first I was on forms of warfarin for about 4 years but suddenly my INR (a measure of blood clotting time) went haywire and eventually it was decided switching to one of the new generation anticoagulants was the only answer to me needing to check my INR weekly (or more often!) as I was about to be in Canada and USA for a month - no handy GP in the village!

I started on 150mg twice daily - the effect lasts 12-14 hours, which means that it is quick to stop if necessary for surgery or other procedures unlike warfarin where the effect lasts a few days. At first there was no antidote for emergency use but one has been developed in the last couple of years for this one. In the first month I had massive bruises on my right leg - we were on a cruise and I kept catching my shin on the metal end of the bed as the cabin was quite narrow - and a couple elsewhere. I spread the doses a bit for a couple of weeks, every 16 hours instead of every 12 hours, the bruising stopped and didn't return when I went back to the normal spacing of the capsules.

I've been on it for just over 3 months now and its fine - no blood tests is a big plus although I'd thought it didn't bother me, my husband also takes warfarin so he has to go once a month and we just went together. I find I do need the full glass of water to wash the capsule down or I get a bit of stomach discomfort - I think that is the stuff the capsule is made of, I never get on well with capsules although I can swallow tablets whole with little or no water! As I say, the bruising has stopped so although there is a slightly lower dosage available and the GP was considering it, I don't think it will be necessary.

Overall I like it - but watch out opening the aluminium wrapping! I sliced my finger with the sharp edge one day which is hardly ideal for someone on an anticoagulant but it is necessary as they are very sensitive to moisture in the air and must only be unwrapped immediately before you take them. The 12 hour spacing is easy - one in the morning when I wake and one in the evening before dinner.