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Should I switch to Lovenox?
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Hi guys,

I've been on Coumadin since December 2011due to PE. I will be on a blood thinner until September as per my doctor. But here is my question:
I am constantly worrying about my inr, what foods to eat, what not to eat. My inr of course is jumping constantly. Not too bad but enough that I have to get my inr checked every 1-2 weeks and plus I worry a lot about it. Its $50 a pop at my doctor's office. So honestly I can't afford to pay that much plus other medical bills. So therefore I am considering switching to Lovenox, which according to my hematologist is as good as coumadin, so gave me a script but now I am trying to decide whether I should switch to Lovenox... I love the idea of eating what I want but I am worried that the bleeding risk with Lovenox is higher. I am not afraid to give myself shots and I've been on Lovenox before. I already called my ins co they said that for a 3 months supply of Lovenox it's: $80 something dollars. Do you think peace of mind and financial savings are worth 2 shots in the stomach? I am just looking to see what other people's experiences are with Lovenox.

Thank you for reading. :)
Posted on 03/14/12, 04:30 pm
17 Replies | Most Recent Add Your Advice
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Reply #1 - 03/14/12  4:50pm
" Hi there, I've had my PE at the beginning of January, and ever since I have been out of hospital, my INR has been all over the place. It dropped massively when I first got out, it took them over a week to get it back to 2, where it stayed for another week, then dropped again, and so on. I had to go to the thrombosis outpatient clinic every day for long periods at a time, and even though they kept increasing my warfarin dose, they just couldn't stabilise my INR. I was on 20mg/day at the end, and very stressed out!
Then I saw the consultant haematologist last week for my follow-up, and after discussing this issue with him, he asked me if I would object to switching to clexane injections (that's what lovenox is called in the UK, I think?). I could have kissed him!

I have now started with the injections, and it's made a world of difference! No more INR, no more worry about what to eat and what not, no more blood tests (after an initial one to check your platelets are OK). I love it and can't recommend it enough! I'm not really worried about the bleeding, the comfort of the injections outweighs all my worries about the side effect (but that might be different for other people!).

It's different here in the UK, I don't have to pay for the blood tests or for the injections (seriously, $50 for an INR check?!? Wow...), so I can't really comment on the financial side of things. But from the peace-of-mind perspective, I'd say go for it! If your doc is OK with it, then it should be OK for you. "
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Reply #2 - 03/14/12  5:00pm
" JBrd,

Thank you for answering my question so quickly! And thank you for sharing your experience with me. You are very sweet! :) "
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Reply #3 - 03/14/12  5:01pm
" I think only you can answer that. I mean, I don't get my INR checked at a doctor's office. I go to a lab and they send the results to my doc and his office calls me either the same day or the next day. So I'm not paying for an office visit just for a simple blood test, which I think is shady that doctor's offices code it as an office visit. Anyway, my labs are pretty cheap so it's not that costly. My warfarin is cheap also.

It can take a while for to dial into the right warfarin dosage for you. For me it took a while. I eat salads and greens and stuff. I just try to be somewhat consistent. There's no reason you can't eat normal while on warfarin.

I don't have any problems injecting lovenox either so if I had to do it, I could. I think if you have the option (many doctors won't just put you on lovenox long term unless there was a medical reason, ie you clot on warfarin, you are warfarin resistant, you have a reaction or something like that) then you should do what you're comfortable with. Maybe make a list of the pros and cons and see what risks are worth it to you. "
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Reply #4 - 03/14/12  5:10pm
" Rmb,

Very sound advice about pro's and con's list. Thank you. "
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Reply #5 - 03/14/12  6:41pm
" Im on the clexane injections like JBrd , purely because im pregnant and its safe in pregnancy. Its really is simple, i inject once daily at the same time (i can go before or over by 2 hours), then you have an inital blood test and if alls ok im tested every 4 weeks (when i go to pregnancy clinic)....
the worse effect for me is purely the psycological effect of injecting lol, im such a wimp around needles, i just shut my eyes an stick it in!!!! "
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Reply #6 - 03/14/12  9:53pm
" I know when i was on fragmin and then on another injectible..... that the cost was close to $80/ injection.
So i really question yourinfo about $80 for a 3 month suppply.

Don't worry about what to eat and not to eat.... eat a healthy conistent diet and live. Trying to worry does not help get everything in order
Just don't binge eat or drink. "
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Reply #7 - 03/15/12  1:44am
" I'm on the injections and for me I like not having to check my inr or worry about it...I tend to really worry about things like that and I also have stomach issues so the less stress the better for me. At first I hated doing the shots but now I'm getting used to it, sometimes they really hurt but I deal with it. It really depends on what you want and how you feel about the pros and cons of each your research and ask your doctors. "
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Reply #8 - 03/15/12  7:45am
" You can get a generic version of lovenox which may be why the cost is so low, along with RX copays on your coverage. Some insurances cap name brand drugs at a certain price too. So it can really depend on the type of RX coverage in the insurance plan.

But yeah, if you're stressed about everything you eat, that doesn't EVER help get your INR squared away. In fact, I really believe screwing around with one's diet makes it that much harder to get into range. "
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Reply #9 - 03/15/12  8:09am
" As others have mentioned, no need to worry about what you eat as long as you maintain it in your daily diet and eat in moderation (no binging).

There are prescription assistance programs out there from each of the anticoagulant companies. Here is the list from our Clot Connect website: "
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Reply #10 - 03/15/12  9:22am
" Wow! You guys are amazing! Thank you for all your help!!! "

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