Warfarin

Outside of more frequent bloodwork and diet restrictions, what are the other downfalls of warfarin? As opposed tio the new drugs, isn't it safer to be able to control the blood levels with regular testing? How do you know what your blood is doing with Eliquis or xarelto? It seems I would have more control over bleeding problems with warfarin. My risk of falling and injury is high because of outdoor work that I do. It just seems the control over bleeding is not there with Eliquis. Pharmacist said he wasn't sure if our small rural hospitals had the antidotes or not. Thanks.

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Erin
Outside of more frequent bloodwork and diet restrictions, what are the other downfalls of warfarin? As opposed tio the new drugs, isn't it safer to be able to control the blood levels with regular testing? How do you know what your blood is doing with Eliquis or xarelto? It seems I would have more control over bleeding problems with warfarin. My risk of falling and injury is high because of outdoor work that I do. It just seems the control over bleeding is not there with Eliquis. Pharmacist said he wasn't sure if our small rural hospitals had the antidotes or not. Thanks.

Although I personally prefer warfarin, the NOAC's allegedly are slightly safer regarding bleeding, so might be warranted if that's your concern. The advantage for some people is that you can feel relatively safe without the need for blood tests (according to large studies). Personally, I like knowing, so don't mind testing.

* perhaps mitigated by the simple antidote with warfarin if you do have a bleed...simply take Vitamin K. There are reports of people on Eliquis dying in the hospital while they attempt to antidote after someone bangs their head.



Edited 1 time(s). Last edit at 09/28/2018 01:07PM by jpeters.

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Erin
Outside of more frequent bloodwork and diet restrictions, what are the other downfalls of warfarin?

Warfarin has higher bleed risks. Its level of protection fluctuates with a number of things such as diet. It has a LOT of interactions with other drugs and foods. Regular testing is required. Some people don't stabilize well on it and have to constantly adjust dosages. It often takes weeks to reach effective levels, and it has a long half-life so stopping it doesn't eliminate the anticoagulant effects quickly.

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As opposed tio the new drugs, isn't it safer to be able to control the blood levels with regular testing? How do you know what your blood is doing with Eliquis or xarelto?

Warfarin is one of the very few drugs that needs regular monitoring, and that's no benefit at all. The fact that levels can change even when you take the correct doses exactly as directed is a huge minus. With the NOACs, there's no need to know what it's doing. You simply take them as directed and they work. This desire so many people have for testing is a holdover from the warfarin days. What other drugs do you take that have tests available for measuring them?

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It seems I would have more control over bleeding problems with warfarin. My risk of falling and injury is high because of outdoor work that I do. It just seems the control over bleeding is not there with Eliquis. Pharmacist said he wasn't sure if our small rural hospitals had the antidotes or not.

Although warfarin can be reversed, that reversal isn't immediate. It takes about 24 hours for vitamin K to reverse the effects. Considering that the half-life of Eliquis is about 12 hours, simply stopping Eliquis will reduce anticoagulant effects just about as fast as vitamin K reduces warfarin's effects. And there is a reversal agent now for all the NOACs except the two newest ones (Sayvasa and Bevyxxa). Those are coming soon.

No, a small rural hospital might not have the reversal agents, but if you're in a small rural hospital with a major bleed somebody already screwed up. You should have been taken to or transferred to a trauma center, or at least a large hospital with full surgical capabilities. Bleeding anywhere except within the brain can usually be controlled with well established measures. External bleeding can almost always be controlled with direct pressure, but internal bleeding demands a surgeon regardless of anticoagulant status. So if you've got a major bleed going on and you're out in the boonies, EMS would fly you directly to a trauma center. A small rural hospital would stabilize the bleeding and transfer you to one.

The only benefits I can think of for warfarin are that it's cheap, it's available almost everywhere, and it is superior for some things such as artificial valves.

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Carey


The only benefits I can think of for warfarin are that it's cheap, it's available almost everywhere, and it is superior for some things such as artificial valves.

I take it because it's cheaper and works better.

Eliquis would be my choice (it was during the two months up until my recent ablation and continues to be for the blanking period) pretty much for all the reasons as set out by Carey above.

Because Warfarin's mechanism of action is to destroy Vitamin K, it destroys K1(which controls clotting and is in leafy greens) as well as K2 (which is made primarily by bacterial action). This is unfortunate as K2, in layman's terms, will "tell calcium where to go." Hence long term use can cause calcification where you don't want it. There are protocols to help offset this by consuming supplemental K2.

Thank you, Carey, for the detailed critique of warfarin. While I really dislike taking Eliquis, it's far better than my experience with warfarin which was scary.

I had just started using it and making the regular trips for the INR testing. About 11 pm in the evening after I was tested,
I received an alarming call from the lab. They said that my INR indicated I was at high risk for a severe bleeding situation and told me that I should sit in one place. Not move around. Not use the stairs where I might fall. And to locate immediately an All-night Pharmacy to pick up the Vitamin K "antidote." We had to locate one then arrange for the Rx to be phone in... then drive to the pharmacy about 6 miles away. I had to be checked again by labs later on.

It turned out that my platelet count was slightly on the low side and apparently that was never noted by the cardiologist and I certainly wasn't warned of the potential risk factor.

After tinkering with variations of the warfarin dosing, continually going for the INR tests, lots of waiting, etc... I decided that I would not continue using the warfarin and would take my chances with using nattokinase.... especially since my events were very infrequent. By then I had changed to a cardiologist in the EP dept of the CCF and I told him why and offered to sign a disclaimer for his liability... which he said wasn't necessary.

I'm mentioning this because it's important for those who do choose warfarin to be aware of their platelet count and if on the low side...be very cautious...esp. if they have an 'active' lifestyle.

As I've mentioned many times, while I have chemical sensitivity issues from the Eliquis, it certainly is far better than my experience with warfarin.... outside of the cost, that is.

Jackie

Like most people, I never had any problems with warfarin. Many have problems with Eliquis. I eat my regular diet, with plenty of leafy greens, and take MK-7 supplement. INR stablizes. I get INR test once a month. The MK-7 derived from Natto raises the INR, so I need only a minimal dose (2.5 mg). I think the glories of Eliquis are WAY over dramatized on this board.

Jackie, you have to initially find out the proper dose so start out with weekly tests. I got one of the alert call initially after being prescribed a dose that was too high. I immediately ate some kale and took a vitamin K tablet, which brought it right down. Sorry the call freaked you out.

GeorgeN, You need to keep consuming foods with Vitamin K. “One good way to think about vitamin K and its importance while taking warfarin is that you need to maintain a balance between the amount of vitamin K in your body and the amount of warfarin prescribed by your health care provider.” You should aim to keep the amount of vitamin K in your diet consistent."

It's a myth that you shouldn't eat any Vitamin K, or that warfarin "kills" all the vitamin K.

[bloodclotrecovery.net]



Edited 2 time(s). Last edit at 09/29/2018 10:39AM by jpeters.

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jpeters
Like most people, I never had any problems with warfarin. Many have problems with Eliquis. I eat my regular diet, with plenty of leafy greens, and take MK-7 supplement. INR stablizes. I get INR test once a month. The MK-7 derived from Natto raises the INR, so I need only a minimal dose (2.5 mg). I think the glories of Eliquis are WAY over dramatized on this board.

Jackie, you have to initially find out the proper dose so start out with weekly tests. I got one of the alert call initially after being prescribed a dose that was too high. I immediately ate some kale and took a vitamin K tablet, which brought it right down. Sorry the call freaked you out.

GeorgeN, You need to keep consuming foods with Vitamin K. “One good way to think about vitamin K and its importance while taking warfarin is that you need to maintain a balance between the amount of vitamin K in your body and the amount of warfarin prescribed by your health care provider.” You should aim to keep the amount of vitamin K in your diet consistent."

It's a myth that you shouldn't eat any Vitamin K, or that warfarin "kills" all the vitamin K.

[bloodclotrecovery.net]

What is the documentation about many have problems with Eliquis? I take Eliquis “for life” so fill me in with The Eliquis problems. You would think they would black box it if it has a big negative input on individuals.
My biggest issue with Eliquis is the Part D Donut 🍩 Hole. It is expensive like all the new NOAC,s.
A issue I do deal with is trying to convince some Physicians young and old that 5 days is not needed to be off the newer NOAC’s to have like a pain injection. I can show them the half life of Eliquis and it flies over there head like a 747. For instance, A colonoscopy requires 5 days off any anticoagulant which is wrong IMO but I do not win.

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smackman
For instance, A colonoscopy requires 5 days off any anticoagulant which is wrong IMO but I do not win.

That is wrong. The usual standard is stopping 5 half-lives, and for Eliquis that would be 60 hours. They're using the warfarin half-life.

And Eliquis has fewer side effects and far fewer drug interactions than warfarin, so that claim isn't really legit. As I said before, cost is really warfarin's only advantage.

My cardiologist said it didn't make any difference to him.....eliquis or xarelto. If echogram shows any thing bad imhave to go on one of them. If not, it is my choice. Since I fell today on cement, I am thinking hard on this.

Xarelto is taken once a day. Eliquis is taken twice a day. I'm unaware of any benefits one of them has over the other other than the convenience of one pill per day vs. two.

If you take your pills (Xarelto or Eliquis) in the morning and then fall on cement, you will have more anticoagulant in your body with Xarelto when you fall.

jpeters - on the warfarin incident. I wasn't freaked out. Just irritated at the inconvenience because the cardiologist prescribing it initially, did not check my platelet count or warn me that dosing might be problematic. Actually, it turned out to be a good experience, because my research led me to the many benefits of nattokinase and by switching to that, I was protected and without the side effects of the meds.

Jackie

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Jackie
jpeters - on the warfarin incident. I wasn't freaked out. Just irritated at the inconvenience because the cardiologist prescribing it initially, did not check my platelet count or warn me that dosing might be problematic. Actually, it turned out to be a good experience, because my research led me to the many benefits of nattokinase and by switching to that, I was protected and without the side effects of the meds.

Jackie

Yes, nobody checked my platelet count either, and it's the first I've heard about the issue. Regarding I high INR, an AC doesn't cause the bleeding, but it's not the time to have a serious head injury. If you cut your arm, it would just mean that the bandage would need to be on for a few minutes longer. I'm wondering if the reason I've been so event free on warfarin isn't the mixture of natural thinners and a diet full of vitamin K? Also, I exercise a lot and am very active.

jpeters - Yes - I totally understand the function of warfarin... to interfere with the action of Vitamin K 1 (phylloquinone) in the clotting cascade or process. And as you point out, it's very important to keep your daily food intake of Vit. K 1 containing foods at a consistent milligram intake when you are taking warfarin.

Semantics.... true the AC doesn't cause the bleeding...rather it allows free flow of blood that is thinner and less apt to clot in normal time frame when there is an impact injury or cut and helps deter arterial blood clots in areas of stagnation. With injuries, if you have low platelets, that time clotting time is impaired - thus the concern is elevated. And, apparently, it's also more difficult to stabilize the INR when on warfarin...or so I was told.

Nevertheless, with low platelets, at least for me, any anticoagulant creates a real mess when there is a cut or bleed as I had with the nosebleed. It's a graphic reminder of the scenario should one be in an auto accident or fall esp. if you hit your head.

Smart exercising is not only good but vital for longevity and good health. Overexercise is detrimental on many levels.

Jackie

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smackman


What is the documentation about many have problems with Eliquis? I take Eliquis “for life” so fill me in with The Eliquis problems. You would think they would black box it if it has a big negative input on individuals.

It hasn't been around long enough to document conclusive long term effects, although there are certainly a lot of associations that remain to be proven. Lightheadness and memory problems keeps coming up in user complaints, so I wouldn't rule out dementia. The pharm industry is unlikely to find any problems, given people are paying over $500 a month given the rising number of people with afib that are routinely placed on it. Check out the recent comments on this article from 2015 from users. Eliquis is a powerful drug.

Warfarin has been around a long time, so the research is in. It's a cancer preventative

"Warfarin's anti-cancer effect was particularly strong among patients taking it for atrial fibrillation, Lorens said."

[medicalxpress.com]


"In our inbox yesterday morning was a media alert from Adverse Events, Inc., regarding the anticoagulant Eliquis (apixaban) and some new cases of colon cancer and liver injury. There is nothing in the official prescribing information regarding such possible complications."

[www.peoplespharmacy.com]

Here's another informal patient testimonial listing of various side effects and symptoms from Eliquis.

[www.medschat.com]

Jackie

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Carey

Although warfarin can be reversed, that reversal isn't immediate. It takes about 24 hours for vitamin K to reverse the effects. Considering that the half-life of Eliquis is about 12 hours, simply stopping Eliquis will reduce anticoagulant effects just about as fast as vitamin K reduces warfarin's effects.

There are numerous warnings against stopping Eliquis cold turkey.

" ELIQUIS can cause bleeding, which can be serious, and rarely may lead to death."
"Stay on Eliquis until your healthcare provider tells you to get off. Suddenly stopping Eliquis can cause serious issues."

Jackie:

I read your UrL on Eliquis, that must be one of the most horrible drugs on the market and you have to pay big bucks for it. I don't know what the answer is, seems to me if you can take Coumadin that would be much better. I couldn't take even Coumadin, it did cause bleeding for me, I don't care what has been said here that AC don't cause bleeding. However, I too have low platelets, which no doubt is a factor.

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jpeters
There are numerous warnings against stopping Eliquis cold turkey.

" ELIQUIS can cause bleeding, which can be serious, and rarely may lead to death."
"Stay on Eliquis until your healthcare provider tells you to get off. Suddenly stopping Eliquis can cause serious issues."

I think you're misinterpreting that warning. The warning is telling patients not to stop Eliquis on their own without MD direction. People stop Eliquis cold turkey all the time. I've done so twice, the most recent instance being two weeks ago and that was per Natale's instructions.

The notion that the NOACs have a rebound effect has been debated at length on stopafib.org, and the bottom line is there's no credible evidence that there is. There are a couple of studies that hint that there could be, but they were retrospective with no way to discern cause-effect. Tapering off is not something I've ever heard of any EP doing.

But really, it's beside the point. If you're got a life-threatening bleed going on they're going to stop your anticoagulant immediately no matter what it is.

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Elizabeth
I read your UrL on Eliquis, that must be one of the most horrible drugs on the market and you have to pay big bucks for it.

The list of side effects and drug/food interactions for warfarin dwarfs the list for Eliquis.

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Carey

I read your UrL on Eliquis, that must be one of the most horrible drugs on the market and you have to pay big bucks for it.

The list of side effects and drug/food interactions for warfarin dwarfs the list for Eliquis.

Warfarin is derived from sweet clover. Although relatively safe, it causes problems for physicians who have to monitor INR for it to be safe. That's not something many are equipped or want to do, which is why they love Eliquis. Even if they have a coumadin clinic, there's no extra charge for the service.

"These findings do not indicate that physicians have inadequate knowledge or expertise (in the trials many were experienced haematologists), but rather reflect the fact that there was often increased frequency of monitoring, contact time, and advice between clinic visits in clinics run by other health-care professionals, a luxury not afforded to physicians. There can be no doubt that managing patients taking warfarin requires a multi-disciplinary and multi-functional approach. Patient education should be an important component, although surprisingly little attention has been paid to this"

[www.ncbi.nlm.nih.gov]



Edited 2 time(s). Last edit at 10/01/2018 03:27PM by jpeters.

I have stopped Pradaxa cold turkey and Eliquis cold Turkey. No issues at all. I actually swapped from Xarelto to Eliquis without issue.
Overall, neither blood thinner bothers me except easy to bleed. Taking only 2.5 mg of Eliquis 2X a day has helped out.

Overall, I hate taking taking Blood thinners BUT I Love Life😀.

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smackman

Overall, neither blood thinner bothers me except easy to bleed. Taking only 2.5 mg of Eliquis 2X a day has helped out.

.

The lower dose, however, has substantial increased stroke risk.

Liz - While I don't enjoy taking the half-dose of Eliquis, it's far safer for me than warfarin. I wouldn't want to revert back to that. And, it is certainly convenient not to have to check INRs - which was never stable for me. While it is costly, depending on what tier the drug plans decide to place it in... (it changes periodically) my Rx plan doesn't always have the best coverage so that's a pain, too, to keep changing plans.

I posted that link because Smackman was asking about reported side effects. Keep in mind, that these side effects are typically highly individualized .... as you'll note from the various experiences reported. I have various forms of skin bumps that look like blemishes at the start... but then when on my shins, expanded to look like a lesion that turned deep red, then blackish blue. Left a bluish mark when the cycle was over. Now on my face, underneath the surface, there are small areas of reddish blotches that look like "petechiae" - often seen in low platelet count - that are new and not there prior to Eliquis. I argued with my Primary Care MD about this and she discounted the whole notion.... but it's confirmed here at this website: [www.ehealthme.com] So, later this month, we'll revisit this topic.

Incidentally, my slightly low platelet count has dropped a few points so either that's another side effect of Eliquis or I'm getting into another phase of something else. Testing should help clarify.

Jackie

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jpeters
Warfarin is derived from sweet clover. Although relatively safe, it causes problems for physicians who have to monitor INR for it to be safe. That's not something many are equipped or want to do, which is why they love Eliquis. Even if they have a coumadin clinic, there's no extra charge for the service.

"These findings do not indicate that physicians have inadequate knowledge or expertise (in the trials many were experienced haematologists), but rather reflect the fact that there was often increased frequency of monitoring, contact time, and advice between clinic visits in clinics run by other health-care professionals, a luxury not afforded to physicians. There can be no doubt that managing patients taking warfarin requires a multi-disciplinary and multi-functional approach. Patient education should be an important component, although surprisingly little attention has been paid to this"

[www.ncbi.nlm.nih.gov]

That's a 12-year old article written before finger stick testing existed. Doctors aren't switching to NOACs because it's more convenient for them. They're switching because the NOACs are equally or more effective, have far fewer side effects, far fewer interactions with other drugs, no interactions with food, don't require monitoring and dosage adjustments, and have a lower bleed risk.

Once again, warfarin's only advantage is cost.

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smackman
I have stopped Pradaxa cold turkey and Eliquis cold Turkey. No issues at all. I actually swapped from Xarelto to Eliquis without issue.

Smackman you were on this board when a person wrote about having a stroke when he switched from Xarelto to Eliquis, so it can happen, maybe you are just lucky. I can't remember who this person was but he hasn't posted since that time, he had said that his memory was affected by the stroke.

I found the message I was speaking of:


Mike E [ PM ]
Re: Eliquis side effects
April 20, 2018 11:41AM Registered: 3 years ago
Posts: 98

In November of 2016 I requested my prescription be changed from Xeralto to Eliquis. I did not feel well on the Eliquis. I informed the NP of it and sent heart rhythm traces and was told to wait and see. By the end of Dec I had a stroke. The Eliquis was not working at all. The stroke was far worse than the worst of my AFIB (after three ablations). I would be very careful of any issues with Eliquis.


Liz



Edited 1 time(s). Last edit at 10/01/2018 09:29PM by Elizabeth.

Xarelto and Eliquis have the same mechanism of action. I'm sorry you had a stroke and I don't know why you did, but it's simply untrue that Eliquis wasn't working at all.

The anti-Eliquis campaign here needs to stop. It's false information. This forum is read by many people who never post ("lurkers"). I was one of them for many years. Think about how your words will affect them before saying it, and ask yourself if it's really supported by decent science or just your personal experience. If it's just your personal experience, make that clear.

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Carey



That's a 12-year old article written before finger stick testing existed. Doctors aren't switching to NOACs because it's more convenient for them. They're switching because the NOACs are equally or more effective, have far fewer side effects, far fewer interactions with other drugs, no interactions with food, don't require monitoring and dosage adjustments, and have a lower bleed risk.

Once again, warfarin's only advantage is cost.

Finger stick testing? You're joking, right? Once again, you're entitled to your own opinion, but for many people (like myself) who have no problems with warfarin, eliquis certainly has no advantages.

BTW/ I have at least a year's supply of Eliquis...samples dumped on the clinic to get everyone using it. I switched to warfarin because Eliquis wasn't able to remove a clot.



Edited 1 time(s). Last edit at 10/02/2018 12:23AM by jpeters.

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Carey


The anti-Eliquis campaign here needs to stop. It's false information.

Hm, I didn't notice any false information, or any anti-Eliquis campaign. How long have you been taking Eliquis?

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jpeters
Finger stick testing? You're joking, right? Once again, you're entitled to your own opinion, but for many people (like myself) who have no problems with warfarin, eliquis certainly has no advantages.

I never said it isn't the best choice for some people. It is for some people for various reasons and I don't argue that you're one of them. I'm not speaking to your situation or any individual's situation. I'm speaking to the broader group of everyone reading this. What I said is the facts are that warfarin is an inferior drug when compared to the NOACs for most people. Singling out Eliquis as some sort of horrible drug is a disservice to people reading this forum because it's just plain inaccurate.

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Carey

What I said is the facts are that warfarin is an inferior drug when compared to the NOACs for most people.

I think you're confusing facts with opinion and theory. Very little is understood about the intricacies of how medications interact within the human body. Making absolute statements like that is absurd and meaningless.

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jpeters


Overall, neither blood thinner bothers me except easy to bleed. Taking only 2.5 mg of Eliquis 2X a day has helped out.

.

The lower dose, however, has substantial increased stroke risk.

Not true for my situation. Dr. Natale is my EP and his professional opinion was 2.5 mg 2X a day of Eliquis. I am not in AFIB. It has to do with my P wave at the mitral valve.
Make sure you understand the diagnosis before blurting nonsense.

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smackman



Overall, neither blood thinner bothers me except easy to bleed. Taking only 2.5 mg of Eliquis 2X a day has helped out.

.

The lower dose, however, has substantial increased stroke risk.

Not true for my situation. Dr. Natale is my EP and his professional opinion was 2.5 mg 2X a day of Eliquis. I am not in AFIB. It has to do with my P wave at the mitral valve.
Make sure you understand the diagnosis before blurting nonsense.

I would suggest you curb your arrogance, Smackman. I'm not an authority on the issue. Obviously, I don't know your "diagnosis".

"ARISTOTLE: Avoid Lower-Dose Apixaban in AF Patients With One Dose-Reduction Criterion"
"Patients should be treated with the effective doses as studied, because using the reduced 2.5-mg twice-daily dose of apixaban in this population could result in preventable strokes," Dr John H Alexander (Duke Clinical Research Institute, Duke Health, Durham, NC) and colleagues write in the analysis, published online July 27, 2016 in JAMA Cardiology.

[www.medscape.com]



Edited 2 time(s). Last edit at 10/02/2018 10:28AM by jpeters.

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jpeters
I think you're confusing facts with opinion and theory. Very little is understood about the intricacies of how medications interact within the human body. Making absolute statements like that is absurd and meaningless.

It's not theory or opinion. I understand that you personally prefer warfarin and that's fine, but if you actually look at the documented side effects, drug interactions, food interactions for both drugs there's really no room for debate.

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Carey

I think you're confusing facts with opinion and theory. Very little is understood about the intricacies of how medications interact within the human body. Making absolute statements like that is absurd and meaningless.

It's not theory or opinion. I understand that you personally prefer warfarin and that's fine.

In my case I had no choice. My situation, however, was unique. I was newly diagnosed, in persistent, and had massive clots. Eliquis simple wasn't powerful enough to get rid of them so I could cardioconvert. I could regulate wafarin to a 3.5 INR and get rid of it quickly. In other situations, I'm sure it works fine. Higher INR comes with increased risk, of course, so when I was in rhythm, I brought it down to 1.8 by eating more Kale.

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jpeters




Overall, neither blood thinner bothers me except easy to bleed. Taking only 2.5 mg of Eliquis 2X a day has helped out.

.

The lower dose, however, has substantial increased stroke risk.

Not true for my situation. Dr. Natale is my EP and his professional opinion was 2.5 mg 2X a day of Eliquis. I am not in AFIB. It has to do with my P wave at the mitral valve.
Make sure you understand the diagnosis before blurting nonsense.

I would suggest you curb your arrogance, Smackman. I'm not an authority on the issue. Obviously, I don't know your "diagnosis".



"ARISTOTLE: Avoid Lower-Dose Apixaban in AF Patients With One Dose-Reduction Criterion"
"Patients should be treated with the effective doses as studied, because using the reduced 2.5-mg twice-daily dose of apixaban in this population could result in preventable strokes," Dr John H Alexander (Duke Clinical Research Institute, Duke Health, Durham, NC) and colleagues write in the analysis, published online July 27, 2016 in JAMA Cardiology.

[www.medscape.com]

May I suggest to YOU to not throw assumptions around when you do not know every patients circumstance. I am a nice old man but I can also turn on my Louisiana charm if needed.
You throw out one random quote and you have Zero evidence of my particular circumstance. I will follow Dr. Natalie’s orders any day over a layman’s opinion.
Have a nice day 😎

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smackman
I will follow Dr. Natalie’s orders any day over a layman’s opinion.
Have a nice day 😎

Let's hope so

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jpeters




That's a 12-year old article written before finger stick testing existed. Doctors aren't switching to NOACs because it's more convenient for them. They're switching because the NOACs are equally or more effective, have far fewer side effects, far fewer interactions with other drugs, no interactions with food, don't require monitoring and dosage adjustments, and have a lower bleed risk.

Once again, warfarin's only advantage is cost.

Finger stick testing? You're joking, right? Once again, you're entitled to your own opinion, but for many people (like myself) who have no problems with warfarin, eliquis certainly has no advantages.

BTW/ I have at least a year's supply of Eliquis...samples dumped on the clinic to get everyone using it. I switched to warfarin because Eliquis wasn't able to remove a clot.

I would love to talk with you by PM on the Eliquis you have and are not using.

When I asked the original question, I was thinking of my brother whose cardiologist told him he could not use xarelto. This was four years ago. He was battling a rare aggressive form of leukemia and I would imagine that is why they chose warfarin. He had thrown a clot before warfarin because a surgeon did not think blood thinner was warranted after cervical surgery. I realize everyone is going to react differently.

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Erin
When I asked the original question, I was thinking of my brother whose cardiologist told him he could not use xarelto. This was four years ago. He was battling a rare aggressive form of leukemia and I would imagine that is why they chose warfarin. He had thrown a clot before warfarin because a surgeon did not think blood thinner was warranted after cervical surgery. I realize everyone is going to react differently.

Your brother had cervical surgery? Unless your brother underwent a sex change operation I think you meant some other type of surgery. ;-)

In any case, warfarin is still preferred in some circumstances such as artificial valves and some diseases like leukemia.

Carey - "cervical" is used in reference to "neck" of various structures.

www.healthline.com/health/cervical-spondylosis

www.verywellhealth.com/cervical-neck-fractures-3119349

Or in dental anatomy ... the cervical area or neck of the tooth.


Jackie

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smackman



I would love to talk with you by PM on the Eliquis you have and are not using.

Your doctor has determined that the benefits justify the costs.

He did not have a sex change. He died of leukemia a year ago. He not only dealt with the leaukemia but also the damage done to his heart by mistakes made in surgery. He had a congenital spine defect which caused his CERVICAL vertebrae to rupture. He was the bravest person I ever knew and the kindest. Thanks to those who tried to explain the differences in blood thinners.

I'm sorry for your loss and sorry if it seemed I was making light of your brother's illness.

Thank you, but I can see where it would be weird when you first read it. I should have written cervical neck. He would have been the first to laugh at the mix up. And I do appreciate your input on both kinds of blood thinner . It makes sense why he was put on warfarin since he dealt with low platelets all the time.

I've used Warfarin for years. I've got a diet that works with plenty of greens. It's not that you can't have them, it's that you have things regularly. And I like salads for lunch on workdays, so that's my routine. I've had weeks where I got tired of them and didn't have them, but no boogy men appeared. I'm perfectly fine and settled with it.

I’m with you, Nancy. This rumor of food restrictions with Warfarin is simply not true. To date, I’ve not seen or heard any TV attorneys drumming up businees for Warfarin.

My husband lasted three weeks on Eliquis. Terrible headsches.

Nancy and Catherine, I'll come to your party....
I chose warfarin over the other anti-coagulants because it is fairly tried and true, and can be reversed. I don't feel that I lead a very blood thinner friendly lifestyle, so reversibility seemed like a good thing. (I plan to be skiing this winter!) Not to mention, and this is purely anecdotal and perhaps not related to the medication, but my dad got put on Pradaxa when it was the latest greatest new med and 6 months later he was dead. Not that I know the Pradaxa was a problem, but it did give me pause about newer meds.

I've also been lucky with the INR biz... My diet plan has been to eat a bag of spinach every week plus whatever else I feel like, and thus far my INR has stayed right between 2 and 3 as they want it. I did read that some people have genetics that make it more difficult to regulate and stabilize INR, so it might not as so easy for everyone. I'm also lucky to work at the med center, so my monthly INR checks just mean a short break at work to walk over and get my finger pricked. I imagine I'd feel different about the whole biz if I had to leave work and drive across town to get tested every month. LOL I'm happy with the warfin.... though I'm hoping to get off it in December!