I took coumadin for the better part of 6 months. Other than having to go to the coumadin clinic almost weekly, I had no adverse reaction. I have been on xarelto since November, 2013. No adverse reaction other than easy bruising. The thing that scares me about xarelo though is the fact that there is no antidote if one was to be injured and could possibly bleed to death.

Hi Eileen, I have been taking Pradaxa for almost 3 yrs. I am tolerating it just fine. I have to take one in the morning and one in the evening...that is a huge nuisance for me. My co pay is $45. a month.

Coumadin requires labwork regularly...sometimes weekly. It is usually monthly if stable. Coumadin requires a lot of consistency. Take it at the same time every day, keep the amount of greens in diet (foods containing vit k) consistent. Any change in medications can effect coumadin dose including many OTC meds.
On the plus side, it is very inexpensive. The new anticoagulants (pradaxa, xarelto, eliquis) are much more expensive depending on your insurance coverage.
You also want to consider the expense of labwork with coumadin. Coumadin has been in use for a long time and most people tolerate it well. I think it depends on your preference which drug you take. They all give very similar protection from stroke, and there is a risk of bleeding with all of them.

Eileen.
I have been taking Coumadin for about 1 hr and have had no problems, except it being out of range a couple of times. In the hospital they put me on Eliquis (2 times daily), but it was too expensive and my Dr. put me back on warfarin for the reasons that they really don't know how the new ones react and they find it hard to stop bleeding. Coumadin has been used of rover 50 yrs. I would prefer to be on the Eliquis but until more research is done and how do we know our INR on these newer ones - with Warfarin they keep track of your INR. I had food poisoning this weekend and it isn't time for another week for INR but I called my co-ag pharmacist and she said, she would feel better if I went and had one tomorrow as not eating (change or diet) can effect it. If too high they lower your dosage and if too thick they increase it and recheck. This is o.k for me as I live only 5 mins. away. I think it comes down to a matter of preference and how safe you feel the new ones aree.
Take care and hope you are feeling better.
Hugs, Christine

I was on Xarelto for a year. I was also taking statins which caused muscle cramps. One strong cramp caused bleeding in my thigh. I did not first understand what was going on and took one more Xarelto. I was hospitalised and needed 2 units of blood and was quite lame for a month. I am now on Warfarin and have not had any problems. No more statins either. Blood tests once a month do not bother me although finding a good vein is more difficult. So, my advice is: be careful with Xarelto and learn to recognize danger signs. Maybe they will find and antidote. Good luck, Marya

I have been taking Marcoumar, which is a vitamin K antagonist, similar to warfarin or Coumadin since the beginning of December last year. I self-monitor AND self-regulate my doses. I live in Switzerland and from the discussions weve had on this forum before I understand that this is not an option in the States (self-monitoring, perhaps but not self-regulating). I had the choice between NOACs and Warfarin, too. I researched and read all I could about both types of anticoagulation and decided that they were both good. Here are the points that weighed in my decision:

NOACs
- no antidote
- a friend of mine was on Xarelto (after a nasty fall from her bike) and had a horrible reaction to it
- new drug what are the long term side effects?
+ easy to take
+ no regular blood tests to keep in range

Warfarin (vitamin K antagonist)
- regular blood tests
- tough to keep in range
- OMG isnt this like RAT POISON??
+ doctors have experience with Warfarin
+ I can self monitor
+ I can self regulate
+ I am in control

It took me one month to get into range and then my doctor let me take over. Its a mutual trust thing here: he trusts me to get it right and stay in range and I trust him to help me if I should have a problem. I test every 6 days (finger prick) but I will probably move it up to 7 in the near future (because I think Im finally getting the hang of it). With such a tight control I have had no problems keeping in range; I can see a trend, figure out why and correct it if necessary before it gets critical. Rat poison? Well, yes. Because it works slowly the rats cant figure out where the poison came from and given enough they will bleed. Which is why we keep track of how much we take so we wont bleed!

I am happy with my decision at the moment but that said I dont count out the possibility of changing to a NOAC someday. The important thing is to be anticoagulated. Like the others said it is a personal decision, everyone is different.

As to your pcp and ep are they disagreeing about being on Warfarin or anticoagulation? Whats your CHADS2VAS2 score? If it is 2 or more anticoagulation is more or less a must, many say if you have a-fib you should be on an anticoagulant. Not to scare you but I was on aspirin and plavix with a CHADS2VAS2 score of 1 and had a TIA (mini-stroke) so it can and does happen! Remember this is YOUR life (not your doctors or eps) YOU have to live with the consequences of a stroke. It may not be fun or convenient to take these meds but the consequences of not taking them could be horrendous.

Hope this helps,
Take care.
atp

The big question is- What is your CHA2DS2Vasc score? Wiki has a nice simple explanation. If your score is 1 or higher, it is recommended that you take an anticoagulant.

The anticoagulants all work. The likelihood of a stroke is much higher than your chance of a bleed if you don't do dangerous things or aren't old and having falls.

Which one to take is based on personal preference and your own situation.

Pradaxa is the most effective in reducing strokes (34% less strokes than Coumadin as compared to Eliquis at 21% less and Xarelto 12% less) according to the neutral websites that compare the 3 drugs as measured against Coumadin.

Eliquis had the lowest bleeding rates at -31%, Pradaxa at -7% and Xarelto at +4%.

Pradaxa had the lowest death rates (-12% with Eliquis -11% close behind. Xarelto -8%).

With all that said, the 3 drugs are so close when you realize these %s are not absolutes. If your stoke risk is 1.4%, the %s above don't move the absolute risk that much. Same thing with the bleeds. Further, in the case of Pradaxa and bleeds, most of them were for over 75 year olds with poor renal function. Actually, Coumadin works quite well also. B if you have trouble regulating your INR, you may be prone to bleeds or not getting protection. Then there are the dietary restrictions. The NOACs have fewer brain bleeds than Warfarin/Coumadin.

Bottom line: You have to take what works for you. GI problems? No Pradaxa. Renal problems? No Pradaxa. However, for me (for example) I'm not 75 and I have no GI problems, so having the lowest stroke and death rates means the most to me. Even if the bleeds are more with Pradaxa than Eliquis (for the whole universe of people), not having a stroke and not dying are more important.

So anyway, the nice thing about Eliquis is that it is 2nd best (of the new 3 NOACs) in reducing strokes, 2nd best in reducing deaths, and best at avoiding bleeds. So that's a good combination. For that reason, Eliquis seems to be the best choice for people over 75, with GI problems, or with renal function problems.

I've heard about too many AFIB patients with zero CHA2DS2Vasc scores having TIAs or strokes.

petey

I have been on warfarin for several years now and no sided affects. I go monthly for blood tests and usually it is right where they want it - 2.5 or so - the worst thing for me is that I cant take any nsaids for pain and I do get pain from arthritis - but I am doing well on tylenol - and my chiropractor really helps me! good luck in whatever you decide.

I am curious why your EP does not want you to take it. Does he recommend something else?

Hi Eileen,
I've been on warfarin for almost 4 years. my diet is pretty consistent so I haven't had a problem staying within the 2-3 INR range. recently I have had some usual bruising. Checked with my cardiologist. He doesn't feel It's of concern. Otherwise no side effects. It works for me.
Eliquis would be my choice if I were to switch.

Annette

HI Everyone. thank you all so much for the information. It means a lot to me to get your input. I am told by my PCP that the 81mg aspirin I am on will not prevent stroke and I should be on Coumadin. My EP says I am in higher risk for bleeding than stroke. My CHA2DS2V score is I believe 2 since I am a 72 year old female. I get severe flare ups of gastritis so had to cut back from 325mg aspirin. Marikay says all can cause bleeding. Petey says Eliquis may be most GI friendly which is a big consideration for me. I guess the "no antidote" thing scares me a little. HECK A LOT. My next EP visit is in June so I have a lot of questions to ask. Also could you please tell me if you also have a cardiologist besides your EP. Thank you all so very much. Happy May Day tomorrow. Hugs Eileen

Correction, meant 1 yr. Not 1 month. Sorry!