Pulmonary Embolism Support Group
By far the most common form of pulmonary embolism is a thromboembolism, which occurs when a blood clot, generally a venous thrombus, becomes dislodged from its site of formation and embolizes to the arterial blood supply of one of the lungs. Symptoms may include difficulty breathing, pain during breathing, and more rarely circulatory instability and death.
I just received this from MedPage today. I'd like people to look at this article and see what they think----- rmb, tnt ---- any others who keep up with the latest? It's long.
This is about Pradaxa, one of the new anticoags that have been developed with a 'selling point ' of no blood monitoring need for INR.
I know that the people who are using this (or a similar one) really like them and have had no problems. I'm not offering this to discount the benefits but because 'full disclosure' was lacking, according to this article. That always bothers me.
"An investigation by The BMJ released online in the journal concluded that "recommendations for use of new generation oral anticoagulants may be flawed because regulators did not see evidence showing that monitoring drug plasma levels could improve safety."
http://www.medpagetoday.com/Cardiology/Arrhythmias/46901
I'm NOT trying to tell people they shouldn't use them! This is just FYI.
This is about Pradaxa, one of the new anticoags that have been developed with a 'selling point ' of no blood monitoring need for INR.
I know that the people who are using this (or a similar one) really like them and have had no problems. I'm not offering this to discount the benefits but because 'full disclosure' was lacking, according to this article. That always bothers me.
"An investigation by The BMJ released online in the journal concluded that "recommendations for use of new generation oral anticoagulants may be flawed because regulators did not see evidence showing that monitoring drug plasma levels could improve safety."
http://www.medpagetoday.com/Cardiology/Arrhythmias/46901
I'm NOT trying to tell people they shouldn't use them! This is just FYI.
http://www.medpagetoday.com/Cardiology/Arrhythmias/46942
I seem to recall during meetings with Boeinger-Ingelheim several years ago some mention about the medication having ties with Exanta. I don't recall the specifics but I wonder if this is why U.S. researchers are less excited about Pradaxa. I don't know if BI meant the science behind the development or if they meant the scientist involved with Exanta. Wish now I asked more questions (lol).
Four years ago I was hospitalized with PEs. Last November, I made an ER visit for Atrial Fibrillation. I had gone off warfarin 6 months after my PE episode. In November, I was briefly put back on warfarin because of the afib.
After seeing a cardiologist, he suggested aspirin rather than warfarin. I went for that in part because I travel and getting tested while traveling was expensive and very inconvenient. Then I read that aspirin is ineffective in preventing stroke for afib patients. I truly did not like the idea of going back on warfarin even though my only side effects are a little bruising at times. So I looked at the newer drugs.
I am making a trip to Peru to see Machu Picchu in October. I'll be there for a couple of weeks and the idea that I'd be hiking at high altitude and eating foods that are potentially different from my "normal" diet concerned me. I'd like to avoid PEs again and the idea of a stroke while I'm there is a non-starter. The new drugs all had a certain appeal. I eliminated Pradaxa pretty early on as it seemed to be less effective than Xaralto and Eliquis. I eliminated Xaralto because it has a half life that is twice as long as Eliquis (around 24 hours for Xaralto and 12 for Eliquis.
So the downsides of these drugs as I understood them were two-fold. First, they are relatively new and there could be side-effects that were not found in the clinical trials. I assumed these could occur only after long term use and could be the reason they were not seen in the trials. Second, there is no anti-dote, a far more concerning reason to me. I hike and run in the mountains and occasional falls are a given. Major bleeding is an almost certain death sentence unless there's an anti-dote. Scrapes and minor bruising should not be a problem.
Recently in talking with my PCP, he informed me that I can't take any NSAID while on Eliquis. Not surprising but disappointing. My only choice when I have minor pain now is Tylenol, something which has always been ineffective for me. I'm not happy about that. I'm not interested in a prescription pain killer unless I have little choice.
I've been on Eliquis now for about 3 months. No side effects yet. So now you've given me one more item to consider. Is the dose appropriate for me? It's a legitimate question.
At the moment, none of the concerns are enough to get me to change my mind about using it. After all, I was on aspirin at first and from what I've read, that was as good as nothing. I've had some minor cuts and had no problems. I've had some aches and pains but nothing serious. But most important, I can take my trip to Machu Picchu, hike at 11,000 feet with a backpack on and not worry about stroke or PEs.
Thanks for sharing the information. I'd rather be informed about the hazards than not.
Todd