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 got my consult letter from my hematologist (UCLA). At the end, when speaking of whether I should be on warfarin indefinitely, he wrote "The future is bright for oral anticoagulants since rivaroxaban is likely to be licensed within the months to come."
I know it's available in Europe/Canada, anyone on it? Differences with warfarin/coumadin? I read from studies there's an increased risk of bleeding, but anyone know if more so than coumadin? Also seems to not require blood monitoring and dietary restrictions.
Not sure what he means about "bright" unless the new drug is better than the rat posion
And I find it amazing that (until now maybe) nothing new has been approved on the oral anticoagulant front since the 1950s!
Chris
I know it's available in Europe/Canada, anyone on it? Differences with warfarin/coumadin? I read from studies there's an increased risk of bleeding, but anyone know if more so than coumadin? Also seems to not require blood monitoring and dietary restrictions.
Not sure what he means about "bright" unless the new drug is better than the rat posion
And I find it amazing that (until now maybe) nothing new has been approved on the oral anticoagulant front since the 1950s!
Chris
First of all, my knowledge is all hearsay and I haven't done much research into this at all. Hopefully some people who do know can either confirm or correct what I write here.
From what I've heard the new drug is better from a monitoring perspective as you don't need all the INR blood tests.
However, what worried me a little is the comparison of what would happen if I cut myself:
If I was on warfarin, I'd be given a vitamin K infusion. Like an antidote so my INR would normalise and I would start clotting again to stop the bleeding.
With the new drug, however, there is no antidote and that is why there is a higher bleeding risk. If you do bleed, it is difficult to stop it.
So, the dilemma is: Go for warfarin which has an antidote but is a pain to control or the supposedly wonderdrug which is easy to take but could be more of a killer if you are involved in an accident?
At the same time, I am sure that pharmacy companies are aware of this and are hopefully busy developing an antidote to act like vitamin K does with warfarin :-)
Personally, I object a little when people refer to warfarin only as a rat poison. Yes, it is used to kill rats, but only because it does the same as with us. It increases the INR and ultimately the rats die of internal bleeding. As usual it is the dose that makes the poison.
http://www.dailystrength.org/c/Deep_Vein_Thrombosis_DVT/forum/7580074-new-drug
Just as an update, Xarelto (Rivaroxaban) as mentioned will be aimed at hip/knee replacement patients. Despite other posts I had mentioned about this medication, it will be early 2010 before it hits the market.
Dabigatran, once approved here in the U.S. wll be marketed for Atrial Fib patients. In Canada and Europe they targeted the hip/knee replacement patients but due to Rivaroxaban being further ahead in hitting the market, they decided to rebrand it a little.
Apixaban, nothing really new to say at this time.
Each of these medication will serve as an alterative to Coumadin; not necessarily a replacement though. For post DVT/PE treatment, more information needs to be collected before approval (at least here in the U.S.) will be passed. Keep in mind, in reality, once any of these products hit the market, though they are being branded for a certain treatment, doctors will eventually start prescribing them for other purposes (DVT therapy, long-term use). I'm going to be writing a story regarding this for an upcoming ethrombosis article for the North American Thrombosis Forum. Once I have completed it I will provide the link to the article.
The folks from Rivaroxaban had came to my house back in May to video a interview with me regarding hip/knee replacement prophylaxis. I finally received a copy of the interview in the mail this week. My organization, NATT, will work on posting it on our website at www.stoptheclot.org in the near future.
HUGS
Ferr